ESPE Abstracts

Background: The hallmark of successful treatment of cryptorchid boys is fertility. However, reported incidences of normal spermiograms for unilateral cryptorchid patients range from 83% to 22%.

Aim of the study: Because, cryptorchid testis has always abnormal histology, performing testicular biopsy it is possible to differentiate between cryptorchid and a normal testicular histology thus validating obtained clinical diagnosis. We hypothesize that in a pool of patients with prescrotal testes a certain number of testes with normal histology could be found, thus explaining the wide range of fertility outcome in unilateral cryptorchid boys.

Patients and Methods: 301 cryptorchid boys having had orchidopexy and testicular biopsy performed by a single surgeon were analyzed. 15 %( 45/301) of boys were found to have prescrotal located testes. Germ cell number and differentiation were estimated by analyzing at least 50 tubular cross-sections.

Results: Sixty-seven percent (30/45) of boys had a normal testicular histology for age [group A] while 15/45 (33%) [Group B] hat a typical cryptorchid testicular histology with reduced germ cell number with 53% 8/15 belonging to high infertility risk group (no Ad spermatogonia and germ cell count <0.2/tubule). Left side was affected in 20 % group A and in 43% in group B.Patients age at orchidopexy was similar; 6.0 (95%CI.4.4-7.9) years (A), 6.6 (95% CI.5.5-7.6) years (B).

Conclusion: High percentage of prescrotal testes with normal histology underscores the need for testicular biopsy to predict patients fertility chances and more exact validate diagnosis; cryptorchidism. Fertility studies without testicular biopsy are subjected to overrepresentation of patients with normal fertility.