A 10-month-old boy has both testes impalpable in the scrotum; both can be palpated at the superficial inguinal pouch and cannot be brought down to the scrotal base. What is the correct management?

• A Reassess at 5 years before deciding on surgery
• B Orchiopexy planned between 6 and 12 months of age, completed before 18 months ✓
• C Hormonal therapy with hCG injections as first-line definitive treatment
• D Orchiectomy because malignancy risk makes preservation unjustifiable

Explanation

Current guidance, reflected in Indian postgraduate teaching, is to perform orchidofunicolysis and orchiopexy between 6 and 12 months, and certainly before 18 months, because germ cell loss begins histologically by this age. Hormonal therapy with hCG gives low success rates and is no longer first-line. Retention preserves the testis because orchiopexy allows easier surveillance for malignancy, which remains elevated even after fixation, and improves fertility potential.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.