AB190. SOH26AB_0370. A case report of bilateral retractile testes in a 56-year-old male: clinical assessment and management considerations

Background: Retractile testes are usually a paediatric finding and are rarely documented in adults, where their clinical significance and management are less clearly defined. We present a case of bilateral retractile testes in an adult and outline a structured approach to assessment and decision-making.

Case Description: A 56-year-old man was referred to the urology clinic for review of previously intermittent testicular pain. History-focused genitourinary examination in standing and supine positions, and review of prior scrotal ultrasound were undertaken. The patient was asymptomatic with no lower urinary tract symptoms or haematuria. Urinalysis was negative for blood and nitrites. Examination revealed a well-developed scrotum, with both testes initially high in the scrotum/inguinal canal but easily manipulated into the scrotum, where they remained transiently without undue tension. There were no palpable masses, no tenderness, and no features to suggest ascending or undescended testes. Ultrasound showed no focal lesions and confirmed testicular mobility. In the absence of fixed extrascrotal positioning, suspicious imaging, or persistent symptoms, conservative management with observation and education on testicular self-examination was chosen. The patient was scheduled for routine surveillance.

Conclusions: This case underscores the need to distinguish adult retractile testes from acquired cryptorchidism, as this directly influences counselling regarding malignancy risk and the need for surgery. Greater awareness of this benign entity can reduce unnecessary orchidopexy while maintaining appropriate clinical vigilance.

Keywords: Adult retractile testes; testicular mobility; cryptorchidism; scrotal examination; case report