A 12-year-old male is sent to your clinic from his new pediatrician's office for evaluation of left cryptorchidism.On examination you cannot palpate a left testicle.You recommend which of the following options to the patient and his parents:
Cryptorchidism is the failure of normal testicular descent during embryologic development. The incidence is 1--2% in full-term infants and up to 30% in premature babies. Operation is indicated after 1 year. Prior to age one, the testis may continue to descend into the scrotum. The cause is unknown. Undescended testes fail in spermatogenic function, but may continue to secrete androgens. Spermatogenic failure is progressive; therefore, surgical exploration and scrotal placement of the testis should be performed before 2-years of age. If placement of the testicle into the scrotum is not possible, then orchiectomy is indicated because of the high risk of testicular cancer when the testis is left in an intraabdominal position.The incidence of testicular cancer in an abdominal testis is 30 times higher than the normal population. After 2- years of age orchiectomy is the treatment of choice because of the cancer risk and poor spermatogenesis.
Wait a few years to see if the testicle descends
Surgical exploration and scrotal placement of the testicle
Orchiectomy
CT scan to look for the testicle