What are the AUA diagnostic guidelines for cryptorchidism?

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

American Urological Association (AUA) guidelines on cryptorchidism contain the following recommendations on diagnosis by primary care providers:

  • Obtain gestational history at initial evaluation of boys with suspected cryptorchidism. (Standard; Evidence Strength: Grade B)
  •  Palpate testes for quality and position at each recommended well-child visit. (Standard; Evidence Strength: Grade B)
  • Refer infants with a history of cryptorchidism (detected at birth) who do not have spontaneous testicular descent by 6 months (corrected for gestational age) to an appropriate surgical specialist for timely evaluation. (Standard; Evidence Strength: Grade B)
  • Refer boys with possible newly diagnosed (acquired) cryptorchidism after 6 months (corrected for gestational age) to an appropriate surgical specialist. (Standard; Evidence Strength: Grade B)
  • Immediately consult an appropriate specialist for all phenotypic male newborns with bilateral, nonpalpable testes for evaluation of a possible disorder of sex development (DSD). (Standard; Evidence Strength: Grade A)
  • Do not perform ultrasound (US) or other imaging modalities in the evaluation of boys with cryptorchidism prior to referral, as these studies rarely assist in decision making. (Standard; Evidence Strength: Grade B)
  • Assess the possibility of a disorder of sex development (DSD) in cases of increasing severity of hypospadias with cryptorchidism. (Recommendation; Evidence Strength: Grade C)
  •  In boys with bilateral, nonpalpable testes who do not have congenital adrenal hyperplasia (CAH), measure Müllerian Inhibiting Substance (MIS or Anti-Müllerian Hormone [AMH]) level), and consider additional hormone testing, to evaluate for anorchia. (Option; Evidence Strength: Grade C)
  • In boys with retractile testes, assess the position of the testes at least annually to monitor for secondary ascent. (Standard; Evidence Strength: Grade B)

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