Tomas Berdych has decided not to be an alternate at the ATP World Tour Finals in London, saying he is again experiencing appendicitis.

The 31-year-old was diagnosed with appendicitis in Cincinnati, and was sidelined for about a month.

"After discussion with doctors in Prague Hospital,” he wrote on Twitter, “I was recommended to have a break for two weeks, and then we will see what [they’re] gonna do with my appendix.”

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A spokesperson for the Czech Tennis Federation said a decision about whether to have surgery would also be considered during the next two weeks.

"If I have to undergo surgery, I would like to do it as soon as possible so I can start getting ready for next season," Berdych said in a statement.

Berdych is No. 10 in the rankings.