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Current Management of Undescended Testes.
1Urology Resident, University of Pennsylvania Perelman School of Medicine.
Current Treatment Options in Pediatrics
|May 10, 2016
Summary
Undescended testes (UDTs) require prompt evaluation and surgical correction within one year of diagnosis after six months of age. Early intervention for UDTs reduces risks of subfertility and testicular cancer.
Area of Science:
- Pediatric Urology
- Endocrinology
- Surgical Management
Background:
- Undescended testes (UDTs) are common in newborns, particularly premature infants.
- Accurate diagnosis involves assessing testis palpability and laterality.
- Imaging is not recommended for UDT workup due to low sensitivity and specificity.
Purpose of the Study:
- To outline the diagnostic and management guidelines for undescended testes.
- To emphasize timely surgical intervention for optimal outcomes.
- To highlight specific evaluations for bilateral non-palpable UDTs.
Main Methods:
- Clinical assessment of testis palpability and location.
- Surgical correction (orchiopexy) based on physical examination findings.
- Diagnostic laparoscopy for non-palpable testes.
- Hormonal and genetic testing for bilateral non-palpable UDTs to rule out CAH and DSD.
Main Results:
- Spontaneous testicular descent occurs within the first six months of life.
- Surgery within one year of diagnosis after six months improves outcomes.
- Laparoscopy aids in locating and treating non-palpable testes.
- Hormonal therapy is ineffective and not recommended for UDTs.
Conclusions:
- Early diagnosis and surgical correction of UDTs are crucial for preventing subfertility and malignancy.
- Management strategies should be tailored to testis palpability and location.
- Thorough evaluation is necessary for bilateral non-palpable UDTs to exclude DSD and CAH.
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