You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.

Table 1.  

Success Rates of Standard Open Orchidopexy for Intra-Abdominal Testis

Table 2.  

Success Rates of One-Step Fowler-Stephens Orchidopexy for Intra-Abdominal Testis

Table 3.  

Success Rates of Two-Step Fowler-Stephens Orchidopexy for Intra-Abdominal Testis

Table 4.  

Success Rates of Laparoscopic-Assisted Orchidopexy for Intra-Abdominal Testis

Table 5.  

Success Rates of Microvascular Autotransplantation Orchidopexy for Intra-Abdominal Testis

Management of Boys With Nonpalpable Undescended Testis

Authors: Ciro Esposito, MD ; Anthony A Caldamone, MD ; Alessandro Settimi, MD ; Alaa El-Ghoneimi, MD, PhDFaculty and Disclosures


Summary and Introduction


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.


Undescended testis (UDT) is one of the most common congenital abnormalities of the genitourinary system in young boys.[1-4] Approximately 1-2% of boys at the age of 1 year have a UDT, the disorder being unilateral in about 90% of cases and bilateral in about 10%, depending on the clinical series.[5-7] About 20% of UDTs are nonpalpable.[8] The testis can be located in the abdomen in some boys, but it might have been pushed into the upper inguinal canal: this disorder is termed ‘peeping testis’.[9-11] In about half of the cases of nonpalpable testis (NPT), a testis is located in the abdominal cavity; the remainder are atrophic, either secondary to an antenatal torsion in utero or agenesis.[12-14]

Despite 15 years of international research on the topic, there are no guidelines on the management of boys with NPT. The management of boys with this disorder is still controversial, and in this Review we aim to summarize the current evidence that is available on the topic and provide an update on how best to manage NPT.

  • Print