Undescended testis: how history and examination may influence treatment

This paper reports a prospective study of 114 boys with 126 undescended testes. The aims were to identify the position of the testis in the first year of life, to document cases of apparent ascent of the testes following a scrotal position in infancy, and to determine whether knowledge of the position of the testis in infancy might be used as a guide in later management. In 92 instances the position of the testis at birth, at 6 weeks and at 1 year of age was recorded; 84 were considered undescended and eight were in the scrotum. There was no clear indication of the position of the testis in the remaining 34. When the position of the testis was known to be undescended from birth to the end of the first year, response to hormonal therapy was disappointing. However, when there was a history of prior descent or when there was no clear information about the position in the first year of life, response to hormonal therapy was rewarding (57%) and this therapeutic modality is recommended prior to surgery for this group of patients.