SNAP SAMP - Answers below:
At what age do you refer a boy with an undescended testicle?
What is the appropriate imaging for a boy with undescended testicle?
What is the correct position in which a pediatric patient should be examined for testicular concerns?
List FIVE locations where a palpable ectopic testicle may be found.
Recently published in Canadian Family Physician (so probably a good thing to know for your exam if it’s in there) is an update on when to refer boys with testicular issues. Here are the main points:
REFER IF your patient meets 1 of the 4 NOTs - the testicle is
Not descended: Palpable but undescended - refer at 6 months*
Not positioned properly: Palpable but in the wrong place - Ectopic**
Not there anymore: Palpable but not in the scrotum - Ascended testis (previously documented as descended but no longer)
Not there: You can’t palpate the testicle at all
*Corrected gestational age
** If palpable, you may find these in the superficial inguinal pouch; less likely, they’ll be somewhere else like the perineum, wrong side of the scrotum, prepubic above the penis, or femoral region.
This article is based on the helpful Clinical Review written by pediatric urologists from Ottawa and Saskatoon, and published in the most recent Canadian Family Physician journal.
See the full article here:
Practical approach to evaluating testicular status in infants and children
Source: Can Fam Physician 2017;63:432-5