Evaluation and Treatment of Cryptorchidism

Cryptorchidism affects an estimated 3 percent of full-term male neonates and up to 30 percent of premature infants. The appropriate evaluation and treatment strategy for cryptorchidism may be influenced by many factors including whether or not the testicle is palpable, whether the condition is present unilaterally or bilaterally, the age at presentation, and comorbid conditions.

The majority of undescended testicles (UDTs) can be located on physical exam. For locating nonpalpable UDT, laparoscopic surgery is routinely used in clinical practice. For the treatment of cryptorchidism, there are three surgical options that are used depending on the location and appearance of the UDTs. The surgical options are primary orchiopexy, one-stage Fowler-Stephens orchiopexy and two-stage Fowler-Stephens orchiopexy.

In addition to surgery, clinical treatment planning (using imaging or hormonal stimulation testing) and intervention approaches including hormonal therapy have been investigated. The authors of this systematic review examined the available evidence on use of imaging and hormonal testing for diagnostic treatment planning and the use of various surgical treatment options for the management of cryptorchidism.