Undescended Testes

INTRODUCTION

A testis that is not in the scrotum may be ectopic, absent, retractile or truly undescended.

THE PROBLEM OF NON-DESCENT

• Testicular dysplasia

• Susceptible to direct violence (if in inguinal region)

• Risk of malignant change (seminoma) is 5–10 times greater than normal

OPTIMAL TIME FOR ASSESSMENT

Between 3 and 6 mths (before development of cremasteric reflex and thus confusion with a retractile testis)

Review 2½–3 yrs—?acquired maldescent

REFER

• All undescended testes by 6 mths

• Acquired maldescent

• Concerned parents

• Doubtful position of testis

OPTIMAL TIME FOR SURGERY

The optimal time for orchidopexy is 6–12 mths. Production of spermatozoa is adversely affected in undescended testes from 2 yrs onwards. Exploration for the uncommon impalpable testis is worthwhile.

HORMONE INJECTIONS

Injections of chorionic gonadotrophic hormones are generally not recommended. They are ineffective except for borderline retractile testes.