Evaluation and Treatment of Cryptorchidism
Publication Date: August 1, 2014
Last Updated: March 14, 2022
Guideline Statements
Diagnosis
Providers should obtain gestational history at initial evaluation of boys with suspected cryptorchidism. (Strong, B)
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Primary care providers should palpate testes for quality and position at each recommended well-child visit. (Strong, B)
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Providers should refer infants with a history of cryptorchidism (detected at birth) who do not have spontaneous testicular descent by six months (corrected for gestational age) to an appropriate surgical specialist for timely evaluation. (Strong, B)
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Providers should refer boys with the possibility of newly diagnosed (acquired) cryptorchidism after six months (corrected for gestational age) to an appropriate surgical specialist. (Strong, B)
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Providers must immediately consult an appropriate specialist for all phenotypic male newborns with bilateral, nonpalpable testes for evaluation of a possible disorder of sex development. (Strong, A)
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Providers should not perform ultrasound or other imaging modalities in the evaluation of boys with cryptorchidism prior to referral, as these studies rarely assist in decision making. (Strong, B)
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Providers should assess the possibility of a disorder of sex development (DSD) when there is increasing severity of hypospadias with cryptorchidism. (Moderate, C)
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In boys with bilateral, nonpalpable testes who do not have congenital adrenal hyperplasia, providers should measure müllerian inhibiting substance or anti-müllerian hormone and consider additional hormone testing to evaluate for anorchia. (Conditional, C)
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In boys with retractile testes, providers should assess the position of the testes at least annually to monitor for secondary ascent. (Strong, B)
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Overview
Title
Evaluation and Treatment of Cryptorchidism
Authoring Organization
American Urological Association