A 6-month-old infant has a retractile testis that has not descended into the scrotum by 6 months. What is the recommended management?

A 6-month-old infant has a retractile testis that has not descended into the scrotum by 6 months. What is the recommended management?

• A. Reassure the parent that the testis will descend on its own.
• B. Refer the infant to a pediatric urologist or surgeon for possible orchiopexy.
• C. Teach the parent to manipulate the testis into the scrotum during diaper changes.
• D. Tell the parent that hormonal therapy may be needed to correct the condition.

Answer: (B)

The key idea is how to manage a testis that has not descended by six months. When descent hasn’t occurred by this age, spontaneous descent becomes unlikely, and the goal shifts to timely surgical correction to protect future fertility and reduce risks such as torsion or malignancy. The best course is to involve a pediatric urologist or surgeon to evaluate and plan orchiopexy, typically done in infancy or early toddler years, to bring the testis into the scrotum and fix it there. Reassuring parents that it will descend on its own isn’t appropriate once six months has passed without descent. Trying to manipulate the testis into the scrotum during diaper changes isn’t a reliable solution and isn’t the recommended management. Hormonal therapy has limited effectiveness and isn’t the standard first-line approach for a persistent undescended testis. So, referring for possible surgical correction is the correct, evidence-based next step.

The key idea is how to manage a testis that has not descended by six months. When descent hasn’t occurred by this age, spontaneous descent becomes unlikely, and the goal shifts to timely surgical correction to protect future fertility and reduce risks such as torsion or malignancy. The best course is to involve a pediatric urologist or surgeon to evaluate and plan orchiopexy, typically done in infancy or early toddler years, to bring the testis into the scrotum and fix it there.

Reassuring parents that it will descend on its own isn’t appropriate once six months has passed without descent. Trying to manipulate the testis into the scrotum during diaper changes isn’t a reliable solution and isn’t the recommended management. Hormonal therapy has limited effectiveness and isn’t the standard first-line approach for a persistent undescended testis. So, referring for possible surgical correction is the correct, evidence-based next step.