Pediatric Surgery Practice Questions

Q: Orchidopexy for undescended testis is recommended at what age?

6 months. **6 months** - The recommended age for **orchidopexy** is between 6 and 12 months, ideally closer to 6 months. - Delaying beyond this period increases the risk of **infertility** and **testicular germ cell tumors**. *3 months* - While some descent can still occur naturally by 6 months, surgery at 3 months is generally **too early**. - This age doesn't allow for sufficient time for potential **spontaneous descent** to occur. *5 years* - Performing orchidopexy at 5 years is considered significantly **delayed**. - This delay substantially increases the risk of **testicular damage**, **infertility**, and **malignancy**. *2 years* - While more optimal than 5 years, 2 years is still on the **later side** of the recommended window for surgery. - Delaying until 2 years may still carry some increased risk for long-term complications compared to surgery between 6-12 months.

Q: A 12-year-old male is sent to your clinic from his new pediatrician's office for evaluation of left cryptorchidism. On examination, you cannot palpate a left testicle. You recommend which of the following options to the patient and his parents:

Surgical exploration and scrotal placement of the testicle. ***Surgical exploration and scrotal placement of the testicle*** - For **undescended testes**, especially after age 6-12 months, **surgical intervention** (orchiopexy) is the recommended management to prevent complications. - In a 12-year-old with a **non-palpable testis**, **laparoscopic exploration** is the preferred diagnostic and therapeutic approach. - This procedure aims to locate the testis and, if viable, bring it into the scrotum, reducing risks of **infertility** and **malignancy**. *Wait a few years to see if the testicle descends* - **Spontaneous descent** of cryptorchid testes rarely occurs after 6 months of age, and almost never after 1 year. - Delaying treatment beyond **6-12 months** increases the risks of infertility, malignancy, and testicular torsion. - At age 12, waiting is not appropriate management. *Orchiectomy* - **Orchiectomy** (removal of the testis) is typically reserved for cases where the testis is severely dysplastic, atrophic, or in certain situations where malignancy is highly suspected. - In a 12-year-old with **non-palpable undescended testis**, the primary goal is usually exploration first to assess viability before considering removal. *CT scan to look for the testicle* - **Imaging studies** such as CT or ultrasound are generally not recommended for localizing non-palpable testes because they are often unreliable and expose the child to unnecessary **radiation**. - **Laparoscopic exploration** is the preferred method for both diagnostic and therapeutic management of non-palpable testes.

Question 1

Orchidopexy for undescended testis is recommended at what age?

Accepted Answer

6 months

Answer

3 months

Answer

5 years

Answer

2 years

Question 2

A 12-year-old male is sent to your clinic from his new pediatrician's office for evaluation of left cryptorchidism. On examination, you cannot palpate a left testicle. You recommend which of the following options to the patient and his parents:

Accepted Answer

Surgical exploration and scrotal placement of the testicle

Answer

CT scan to look for the testicle

Answer

Orchiectomy

Answer

Wait a few years to see if the testicle descends

Pediatric Surgery — MCQs

Pediatric Surgery — MCQs

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