What are the AUA treatment 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

The AUA guidelines recommend against the use of hormonal therapy to induce testicular descent, due to low response rates and lack of evidence for long-term efficacy. (Standard; Evidence Strength: Grade B). AUA recommendations for treatment by surgical specialists are as follows:

  • If spontaneous testicular descent has not occurred by 6 months (corrected for gestational age), perform surgery within the next year. (Standard; Evidence Strength: Grade B)
  •  In prepubertal boys with palpable, cryptorchid testes, perform scrotal or inguinal orchidopexy. (Standard; Evidence Strength: Grade B)
  • In prepubertal boys with nonpalpable testes, perform examination under anesthesia to reassess for palpability of testes. If nonpalpable, surgical exploration—and, if indicated, abdominal orchidopexy—should be performed. (Standard; Evidence Strength: Grade B)
  • At the time of exploration for a nonpalpable testis in boys, identify the status of the testicular vessels to help determine the next course of action. (Clinical Principle)
  • In boys with a normal contralateral testis, consider performing orchiectomy (removal of the undescended testis) if a boy has a normal contralateral testis and either very short testicular vessels and vas deferens, dysmorphic or very hypoplastic testis, or postpubertal age. (Clinical Principle)

The AUA advises that providers should counsel boys with a history of cryptorchidism and/or monorchidism, and their parents, regarding potential long-term risks and provide education on infertility and cancer risk. (Clinical Principle)


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