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Commissioning Guide - Paediatric Orchidopexy for Undescended Testis

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17 August 2015

This is an important document which should be studied by those urologists carrying out general paediatric urology. However, much of the guidance is intended to encourage earlier referral by GPs, and the following are noteworthy issues of which local GPs should be aware:

  • Bilateral undescended testes (UDTs) need urgent paediatric assessment to exclude ambiguous genitalia,
  • If a UDT is still not in the scrotum after 3 months of age, the GP must refer the child for further advice,
  • Boys with a UDT should be seen and assessed by a urologist by 6 months of age,
  • Surgery is recommended between 6 and 18 months of age, depending on local resource and expertise. (It should be borne in mind that there are increased anaesthetic risks in children <1 year old, but urological outcome is probably better if orchidopexy is undertaken earlier. This may have implications for DGHs where elective paediatric surgery is only undertaken on children >1 year old),
  • Palpable UDTs may operated on in local hospitals,
  • Non-palpable testes should be referred to tertiary urology, in case laparoscopy needed and
  • UDTs associated with a penile anomaly should be referred to tertiary urological services.

Download the Commissioning Guide for Paediatric Orchidopexy for UDT

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