Testis never palpable:
(1) testicular regression syndrome (see previous section)
(2) testicular hypogenesis
(a) genetic disorders: Klinefelter's syndrome, Noonan's syndrome, myotonic dystrophy
(b) hypothalamic-pituitary disorders
(c) testicular dysfunction
(3) ectopic testes (in the abdomen, thigh, elsewhere)
(4) incomplete descent or maldescent (in the inguinal canal)
Testis previously palpated, but no longer:
(1) testicular atrophy syndrome (history of inguinal hernia surgery or trauma)
(2) obscuring obesity
(3) obscuring scar
(4) retractile testis (testis may come and go)
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Etiology
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Workup
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genetic disorder
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family history, cytogenetics, serum testosterone
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hypothalamic-pituitary
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CT skull, gonadotropins (LH and FSH), serum testosterone
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testicular dysfunction
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gonadotropins (LH and FSH), serum testosterone, sperm analysis, referral for specialized testing
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positional or obscured
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ultrasound and/or laparoscopic examination, serum testosterone
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