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Undescended testes (cryptorchidism) in children: Management

Christopher S Cooper, MD, FACS, FAAP
Steven G Docimo, MD
Section Editors
Jan E Drutz, MD
Laurence S Baskin, MD, FAAP
Mitchell E Geffner, MD
Deputy Editor
Mary M Torchia, MD


Cryptorchidism is the most common congenital abnormality of the genitourinary tract [1]. Most cryptorchid testes are undescended, but some are absent (due to agenesis or atrophy). True undescended testes have stopped short along their normal path of descent into the scrotum (figure 1). They may remain in the abdominal cavity (picture 1) or they may be palpable in the inguinal canal (intracanalicular) or just outside the external ring (suprascrotal (picture 2)) [2].

An overview of the management of undescended testes in children will be provided here. The clinical features and evaluation of undescended testes in children are discussed separately. (See "Undescended testes (cryptorchidism) in children: Clinical features and evaluation".)


Cryptorchidism – Cryptorchidism by definition suggests a hidden testis: a testis that is not within the scrotum and does not descend spontaneously into the scrotum by four months of age (or corrected age for premature infants) (picture 3). Cryptorchid testes may be absent or undescended.

Absent testis – An absent testis may be due to agenesis or atrophy secondary to intrauterine vascular compromise (eg, prenatal testicular torsion), also known as the "vanishing testis syndrome" or testicular regression syndrome [3]. Boys who have bilaterally absent testes have anorchia. (See "Neonatal testicular torsion", section on 'Prenatal'.)

Undescended testes – True undescended testes have stopped short along their normal path of descent into the scrotum (figure 1). They may remain in the abdominal cavity (picture 1) or they may be palpable in the inguinal canal (intracanalicular) or just outside the external ring (suprascrotal (picture 1)) [2].

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Literature review current through: Sep 2017. | This topic last updated: Sep 12, 2017.
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