When should a child with an undescended testis be referred to a urologist?
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Infants with an undescended testis should be referred between ages 6 and 15 months, since almost all who experience spontaneous descent do so by 6 months (strength of recommendation [SOR]: A, extrapolation from cohort studies). The incidence of germ cell aplasia in undescended testes begins to rise at 15 months (SOR: C, extrapolation of observational studies); however, evidence is inconclusive that orchiopexy at this age results in higher rates of paternity success (SOR: B, retrospective cohort study). Orchiopexy may allow earlier detection of testicular tumors (SOR: C, expert opinion), but it has not been shown to reduce the risk of testicular cancer (SOR: B, retrospective cohort study) or improve 5-year survival rates for those patients diagnosed with testicular cancer (SOR: B, retrospective cohort study).
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