The Biopsy of the Undescended Testis: Pros and Cons

Undescended testis is the most common disorder of the urogenital system. It has been shown that spermatogenesis is affected in cryptorchid boys after the 9 months of age when spermatogenic index decreases rapidly. There are many studies about possible consequences of this condition such as infertility or testicular cancer. Although orchidopexy before puberty decreases the risk of testicular cancer it does not completely eliminate it. If the child underwent bilateral orchidopexy it will carry 6-fold greater risk of being infertile when compared with unilaterally cryptorchid men and general population. There is still a debate if the biopsy should be taken during orchidopexy. The result of biopsy should give us an idea of the number of germ cells and adult dark spermatogonia which hold a high predictive value of future spermatogenesis. Scientists still have many questions that require answers such as if there is any less invasive way to find out about the level of adult dark spermatogonia at the time of orchidopexy such as measurement of testicular volume. Although testicular biopsy is not a standard part of the protocol for orchidopexy, detecting low adult dark spermatogonia at the histopathological examination could point out the patients for postorchidopexy hormonal therapy.