De niet-scrotale testis: argumenten vóór vroeg behandelen, mits retractiele testis en verworven niet-scrotale testis zijn uitgesloten

- Guidelines for the treatment of undescended testis (UDT) are sparse. Often an operation in the second year of life is advised.

- Recent data indicate that the normal maturation process, which will ultimately lead to a normal quantity and quality of germ cells, is impaired as early as in the first half year of a newborn’s life. None of the guidelines take this into account. Spontaneous descent after the fourth month following birth, of testes that have previously not descended, hardly ever occurs.

- No differences have been shown in complication numbers between surgery before and after the first birthday. Orchidopexy prior to the 13th birthday reduces the risk of testicular cancer.

- Therefore, based on these data, it is advised to perform orchidopexy in the second half of the first year of a newborn’s life. In older boys a UDT must be treated before the 13th birthday.

- In the Netherlands a lot more orchidopexies are done despite what may be expected based on prevalence numbers of UDT: testes retaining a normal volume that would most probably have descended spontaneously come puberty.

- It remains important to carry out a careful physical examination and document the position of the testes soon after birth, and later on if UDT is suspected, to avoid unnecessary operations on retractile testes and acquired UDT.

Ned Tijdschr Geneeskd. 2008;152:253-8