Treatment Options for Undescended Testis (Cryptorchidism)

Evaluation and Timing of Treatment

Infants with cryptorchidism detected at birth who do not have spontaneous testicular descent by 6 months should be referred to an appropriate surgical specialist 4
Boys with newly diagnosed cryptorchidism after 6 months of age should also be promptly referred to a surgical specialist 4
Imaging studies are not recommended prior to referral as they rarely assist in decision making 4
For phenotypic male newborns with bilateral nonpalpable testes, immediate specialist consultation is required to evaluate for possible disorders of sex development 4

Early surgical intervention reduces the risk of impaired fertility potential 4
Testes that remain undescended by 6 months are unlikely to descend spontaneously 4
Continued damage may occur to testes that remain in a non-scrotal location 4
Treatment addresses increased risks of impaired fertility potential 4, testicular malignancy 1, testicular torsion 1, and associated inguinal hernia 1, 2, 3

Successful scrotal repositioning of the testis may reduce but does not completely prevent the potential long-term risks of infertility and testicular cancer 1, 2, 3
Hormonal therapy alone is not recommended as primary treatment for cryptorchidism 4
For bilateral nonpalpable testes in a phenotypic male newborn, immediate specialist consultation is required to rule out disorders of sex development 4
A newborn with bilateral nonpalpable gonads should not be circumcised until after workup is complete 4
When cryptorchidism is present with phallic anomalies, evaluation for disorders of sex development should be considered 4

Appropriate counseling and follow-up is essential after treatment 1, 2, 3
Monitoring for testicular position and development should continue throughout childhood and adolescence 1, 2, 3