Recently, in The Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine), three papers expressing with conflicting opinions on the management of primary and acquired non-scrotal testes (NST) in boys were published. In this paper, the Paediatric Urology Workgroup of the Dutch Urological Association summarizes its current recommendations on treatment strategies for this condition: Primary NST is best treated with early orchiopexia at age > 6 months. Therefore, boys with NST should be referred as early as the age > 6 months. Boys with non-palpable NST should always be referred for analysis regardless of their age. The best treatment for acquired NST is less clear than that for primary NST. However, the fact that recent studies show a diminished risk for testicular cancer if orchiopexia is performed before puberty, is a strong argument to not postpone orchiopexia until puberty or later, even if a significant proportion of these testes will descend around puberty. In addition, it has not been proven that the non-scrotal position, of an acquired NST for a number of years, has no deleterious effects on the testis and its later fertility potential. The above-mentioned recommendations are in agreement with the recently published 'Nordic consensus on treatment of undescended testes'.
Comment On: Ned Tijdschr Geneeskd. 2008 Feb 2;152(5):243-518333537
Comment On: Ned Tijdschr Geneeskd. 2008 Feb 2;152(5):246-5218333538
Comment In: Ned Tijdschr Geneeskd. 2008 Nov 15;152(46):2534; author reply 253419055262