Treatment for Atrophied Testicle

Diagnosis and Assessment

Testicular ultrasound should be performed to confirm atrophy, assess the contralateral testis, and rule out underlying pathology such as testicular cancer, as recommended by the European Society for Medical Oncology and the National Comprehensive Cancer Network 1, 2
Blood tests should include total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and tumor markers (AFP, β-HCG, LDH) if malignancy is suspected, according to the European Society for Medical Oncology and the National Comprehensive Cancer Network 2, 3
Testicular volume <12 ml is considered atrophic and warrants further evaluation, as stated by the European Society for Medical Oncology 3, 4

In adults with unilateral undescended testis and atrophy, orchidopexy may be offered to preserve androgen production and fertility potential, as suggested by the European Association of Urology and the American Urological Association 5, 6
If the contralateral testis is normal, orchiectomy may be considered due to the increased risk of testicular cancer in the undescended atrophic testis, according to the American Urological Association and the European Association of Urology 6

Sperm banking should be considered before any surgical intervention or radiotherapy that might affect fertility, as recommended by the European Society for Medical Oncology and the American Society for Reproductive Medicine 1, 3
In cases of bilateral testicular atrophy, organ-preserving surgery should be considered when possible, as stated by the European Society for Medical Oncology and the American Urological Association 3, 7

Regular monitoring of hormone levels and testicular volume is recommended, as suggested by the European Association of Urology 5
Self-examination should be taught to patients with a history of testicular atrophy due to the increased risk of testicular cancer, according to the American Urological Association and the European Association of Urology 6
Long-term follow-up is necessary to monitor for late complications including hypogonadism and malignancy, as recommended by the European Association of Urology and the American Urological Association 5, 6

Failing to consider fertility preservation before definitive treatment, as emphasized by the European Society for Medical Oncology and the American Society for Reproductive Medicine 1, 3
Overlooking the increased risk of testicular cancer in patients with atrophic testes, particularly those with a history of cryptorchidism, as noted by the American Urological Association and the European Association of Urology 6