Doctor, my child’s testis cannot be felt! Should we do an ultrasound examination?

Is an ultrasound necessary in a child who has an undescended testis?

Almost every patient that comes to me for consultation for undescended testis, comes armed with an ultrasound (USG) report, that the parent will promptly proceed to show me after the initial formalities, even before I have had a chance to ask as to why they are consulting me.
The sad part is that ultrasound is not only unnecessary but actually misleading in children with undescended testes [1].

USG is accurate in predicting examination findings in only 54% of children. Additionally it delays required surgery in infants by as many as 3 months.
The algorithm for managing undescended testis only requires whether an experienced pediatric surgeon can palpate the testis or not. So please do not get unnecessary tests done.
1. Ultrasound Overused to Diagnose Undescended Testicle