A 14-month-old boy is brought for evaluation of an empty right scrotum noted since birth. On examination, the testis is palpable in the superficial inguinal pouch and does not descend into the scrotum even when the child is examined squatting. What is the correct management?

• A Perform orchidofunicolysis and orchidopexy now ✓
• B Start intramuscular hCG injections and reassess after 3 months
• C Reassure and review at 5 years of age
• D Perform orchidectomy with prosthesis insertion

Explanation

Current guidance is orchidopexy between 6 and 12 months of age, and certainly before 12 to 18 months, because germ cell loss begins after the first year and later surgery does not fully reverse fertility impairment. Hormonal therapy with hCG has low success rates and is no longer recommended as primary treatment. Observation until school age risks irreversible tubular damage and doubles the baseline malignancy risk that orchidopexy partially mitigates and allows surveillance.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.