title: Evaluation and management of the infant with cryptorchidism.
abstract: OBJECTIVE
  Normal testicular descent is now recognized to occur in two steps with the first, transabdominal stage controlled by insulin-like hormone 3. The second, inguinoscrotal stage is controlled by androgens, mostly indirectly via the genitofemoral nerve, which appears to direct the migration of the gubernaculum to the scrotum. Undescended testis (UDT) is multifactorial, with only some of the genes identified. This review highlights recent developments that are leading to changes in practice.
  
  
  RESULTS
  There is an emerging consensus among pediatric surgeons and urologists about the management of UDT with recommendations that the diagnosis of congenital UDT should be confirmed at 3-6 months of age and orchidopexy done at 6-12 months of age. With the recommendations for early surgery, recent studies focus on the complications of orchidopexy, to determine whether this is higher in infants than older children. In addition, there is general acceptance of the existence of 'acquired' UDT, which develops after about 2 years of age, but treatment for this group remains controversial.
  
  
  CONCLUSIONS
  Evaluation of children with UDT now needs to be separated into the assessment of possible congenital UDT in infants at 0-6 months, for orchidopexy before 12 months, and preschool boys, who may be developing acquired UDT.
authors.affiliation: aF Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute bDepartment of Urology, The Royal Children's Hospital, Parkville, Victoria cDepartment of Paediatrics, University of Melbourne, Melbourne, Australia dDepartment of Paediatric Surgery and Surgical Clinic, Rigshospitalet, Copenhagen eFaculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
authors.forename: John M
authors.initials: JM
authors.lastname: Hutson
authors.forename: Joergen
authors.initials: J
authors.lastname: Thorup
mesh_terms: D002675:Child, Preschool; D003456:Cryptorchidism / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D056126:Orchiopexy / Q000379:methods*; D017410:Practice Guidelines as Topic; D013737:Testis / Q000254:growth & development / Q000503:physiopathology*; D016896:Treatment Outcome