What is the role of imaging studies in the workup of cryptorchidism?

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

American Urolological Association guidelines recommend against imaging studies in boys with cryptorchidism prior to surgical referral. [1] Radiologic studies to localize the testis are of very little value. The overall accuracy of radiologic testing for undescended testis is only 44%. [46]

Computed tomography (CT) scanning and ultrasonography yield high false-negative rates in the evaluation of a nonpalpable testis and are not recommended. [47] Magnetic resonance angiography (MRA) has been reported to have a nearly 100% sensitivity but requires sedation or anesthesia and is expensive and may not be cost-effective. To date, examination by a pediatric urologist has proven to be more valuable than ultrasonography, CT scanning, or MRA.

Abdominal and pelvic ultrasonography combined with genitography should be used when intersexuality is suspected. Ultrasonography of the upper urinary tract has been investigated because of the embryologic association of the ureteric bud and the Wolffian duct, but the yield of significant urinary pathology is no greater than the incidence of anomalies found in the general population. [48]

For discussion and images, see Cryptorchidism Imaging.

 


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