Review Article
Retractile testes: A review of the current literature

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Abstract

The current evidence for the management of retractile testes is discussed in this review. Issues such as clinical definitions, natural history, possible outcomes and evidence for surgical intervention are evaluated. After reviewing the literature, the authors summarize that currently there is not enough evidence to warrant surgery for retractile testes, but rather a strategy of surveillance should be adopted.

Introduction

Undescended testes (UDT) are one of the most common paediatric surgical conditions. The management of congenital and acquired UDT is not disputed and remains orchidopexy. However, the topic of retractile testes is one which still generates debate with regard to definition, natural history, and indications for and timing of intervention. We review the current literature on retractile testes in an attempt to provide an evidence-based management strategy.

Section snippets

Definitions

Retractility of the testis from the scrotum into a suprascrotal position is normal in prepubertal boys. It is brought about by the contraction of the cremaster muscle in response to temperature, stimulation of the superficial reflex via the genital branch of the genito-femoral nerve, and by extreme emotion such as anxiety [1]. The strength of the cremaster contraction is extremely variable between individuals, with age and with the examination situation. After birth, the testes are relatively

Discussion

It is now accepted that an UDT may be congenital or acquired, accounting for the bimodal age distribution of orchidopexy reported by most groups [2], [3], [8], [9], [10], [11], [12], [13], [14]. The recommended timing for surgery in a congenital UDT is before 12 months [22] and for acquired UDT at time of diagnosis [8].

The retractile testes remain an area of contention. Does a retractile testis represent a descended testis in the process of ascending or is it a descended testes with a strong

Funding

None declared.

Conflict of interest

None declared.

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  • Cited by (0)

    This work was done whilst working at the above institute.

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