Incidence
3-5% of term neonates, higher incidence in preterms (up to 30%); decreases to 0.7-1% at 1 year of age.
Classification
3-5% of term neonates, higher incidence in preterms (up to 30%); decreases to 0.7-1% at 1 year of age.
Clinical features
Clinically, a testis is undescended on physical examination if it is not palpable in the scrotum or cannot be brought to the bottom of the scrotum. One must differentiate from retractile testes, which can be coaxed to the scrotal position, and ectopic testes, which may be found in locations out of the normal line of descent — in the lower part of the abdomen, perineal, front of thigh. pre-penile or crossed scrotal.
Management
Clinical examination for undescended testis is adequate to proceed for treatment. An ultrasound examination can identify testis outside of the abdominal cavity and assess its size. However, the sensitivity and specificity for diagnosing intra-abdominal testis in the setting of impalpable testis is low at 45% and 78%, respectively.
CT is not recommended for such children in view of its high radiation dose. Conventional MRI has a sensitivity of 85% and a specificity of 87.5%. Gadolinium-enhanced MRI has a higher sensitivity and specificity of 96% and 100%, respectively. However, not identifying a testis on MRI does not completely exclude its absence. They would still need a laparoscopy.