At a 9-month well-child visit, a boy has a testis that can be brought into the bottom of the scrotum by gentle manipulation but immediately retracts to the superficial inguinal pouch when released. Growth and position were normal on earlier visits. The correct management is:

• A Orchiopexy within the next month
• B Referral for orchidectomy
• C Human chorionic gonadotropin stimulation course now
• D Reassurance with annual review, as this is a retractile testis ✓

Explanation

A testis that reaches the scrotum, however briefly, and was previously documented in the scrotum is a retractile testis caused by an active cremasteric reflex, which is maximal between 2 and 7 years of age. It requires only reassurance and periodic review because it carries normal fertility potential. True undescended testes, which never reach the scrotum even under manipulation, warrant orchiopexy between 6 and 12 months of age.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.