What are the European guidelines on cryptorchidism?

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

Guidelines on cryptorchidism from the European Association of Urology and the European Society for Paediatric Urology include the following recommendations [58] :

  • Do not offer medical or surgical treatment to boys with retractile testes but follow up closely until puberty (Level of Evidence [LE] 2a, Grade A)
  • Offer surgical orchidolysis and orchidopexy before the age of 12 months, and by 18 months at the latest (LE 2b, Grade B)
  • Evaluate male neonates with bilateral non-palpable testes for possible DSDs (LE 1b, Grade A)
  • In boys with non-palpable testes and no evidence of DSDs, offer laparoscopic intervention because of its excellent sensitivity and specificity in identifying an intra-abdominal testis, as well as the possibility for subsequent treatment in the same session (LE 1a, Grade A)
  • Do not routinely offer hormonal therapy, either in an adjuvant or neo-adjuvant setting, for testicular descent; patients have to be evaluated on an individual basis (LE 2a, Grade C)
  • In cases of bilateral undescended testes, offer endocrine treatment to possibly improve further fertility potential (E 4, Grade C)
  • For an undescended testis in a post-pubertal boy or older who has a normal contralateral testis, discuss removal with the patient/parents because of the theoretical risk of a later malignancy (LE 3, Grade B)

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