What is included in the physical exam of cryptorchidism?

Updated: Dec 17, 2020
  • Author: Joel M Sumfest, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Considerations and questions in the physical examination include the following:

  • The patient should be warm and relaxed for the examination.

  • Observation should precede the examination.

  • The patient should be placed in the frog-leg position for examination;  this is especially useful in obese children with fatty infiltration of the scrotum and when retractility is a concern.

  • Milk down, palpating from iliac crest to scrotum (soap or lubrication on fingertips may help).

  • What are the features of the scrotum and its contents (eg, hypoplasticity, bifidity, rugae, transposition, pigmentation)?

  • Is the contralateral testicle hypertrophic?

  • Is the undescended testis located in an unusual position, such as in an ectopic site (ie, superficial inguinal pouch or transverse scrotal, femoral, prepenile, perineal, or contralateral hemiscrotum)?

  • Note the presence of any hypospadias or chordee. Does the patient have a normal stretched penile length?

  • If the findings are equivocal, perform serial examinations.


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