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  • Review Article
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Management of boys with nonpalpable undescended testis

Nature Clinical Practice Urology volume 5, pages 252–260 (2008)Cite this article

Abstract

Cryptorchidism is one of the most common genitourinary disorders in young boys. Although the management of boys with palpable testis is standardized, there are no formal guidelines for the management of boys with nonpalpable testis. In this Review we look at the current trends in the diagnosis and treatment of this disorder, as well as the indications for therapy and surgical procedures. On the basis of current evidence, we find that there is no optimum orchidopexy technique for the treatment of intra-abdominal testis, although it is preferable to adopt techniques that preserve the spermatic vessels. We also briefly examine the follow-up of patients with this disorder and its common complications. As yet, there are no data that assess the potential of laparoscopic orchidopexy being a risk factor for impaired fertility later in life.

Key Points

  • Undescended testis is one of the most common congenital abnormalities of the genitourinary system; about 20% are nonpalpable

  • Ultrasonography in unnecessary in most cases of unilateral nonpalpable testis

  • Diagnostic laparoscopy seems to be the gold standard for the exploration for nonpalpable undescended testicles

  • On the basis of current evidence, there is no optimum orchidopexy technique for the treatment of intra-abdominal normotrophic testis, although empirically it is preferable to adopt techniques that spare the spermatic vessels

  • There is a need for long-term follow-up and multicentric prospective studies that evaluate the various laparoscopic approaches

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Figure 1: Algorithm for a suggested approach to patients with NPT.

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Acknowledgements

Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. C Esposito is Associate Professor of Pediatric Surgery in the Department of Pediatrics and A Settimi is Professor of Pediatric Surgery and Head of the Department of Pediatric Surgery at the University of Naples “Federico II”, Naples, Italy.,

    Ciro Esposito & Alessandro Settimi

  2. AA Caldamone is Professor of Pediatric Surgery and Urology in the Division of Urology, Hasbro Children's Hospital, Brown University School of Medicine, Providence, RI, USA, and,

    Anthony A Caldamone

  3. A El-Ghoneimi is Professor of Pediatric Surgery in the Faculty of Medicine of the University of Paris VII and Head of the Department of Pediatric Surgery and Urology at the University Hospital of Robert Debré, Paris, France.,

    Alaa El-Ghoneimi

Authors
  1. Ciro Esposito
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  2. Anthony A Caldamone
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  3. Alessandro Settimi
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  4. Alaa El-Ghoneimi
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Correspondence to Ciro Esposito.

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Esposito, C., Caldamone, A., Settimi, A. et al. Management of boys with nonpalpable undescended testis. Nat Rev Urol 5, 252–260 (2008). https://doi.org/10.1038/ncpuro1102

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