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Cryptorchidism: a morphological study of 670 biopsies
A M Schindler1, P Diaz, A Cuendet
1Department of Pathology, University of Geneva, Switzerland.
Helvetica Paediatrica Acta
|October 1, 1987
Summary
Cryptorchidism, or undescended testes, significantly reduces germ cell count in boys. Orchidopexy surgery does not improve these counts, suggesting no optimal timing for intervention based on germ cell preservation.
Area of Science:
- Pediatric Urology
- Andrology
- Reproductive Medicine
Background:
- Cryptorchidism is a common congenital condition in boys, characterized by undescended testes.
- The impact of cryptorchidism on testicular germ cell population and the efficacy of surgical correction remain areas of clinical interest.
Purpose of the Study:
- To evaluate the spermatogonial counts in cryptorchid testes and associated scrotal testes.
- To assess the effect of orchidopexy on germ cell numbers and testicular development.
- To investigate potential associations between cryptorchidism, associated anomalies, and germ cell status.
Main Methods:
- Histological examination and spermatogonial counts (Mancini's method) of testicular biopsies from 512 boys with empty scrota.
- Analysis of biopsies from cryptorchid testes (441) and scrotal testes (229).
- Comparison of germ cell counts in relation to age, bilaterality, intra-abdominal location, and post-orchidopexy status.
Main Results:
- Nearly all cryptorchid testes showed diminished germ cell populations.
- Spermatogonial counts were particularly low in bilaterally intra-abdominal testes.
- Scrotal testes in unilateral cryptorchidism cases exhibited germ cell loss in 30.1% of instances.
- Orchidopexy did not improve germ cell numbers; postoperative changes were limited to increased tubular diameter.
- No malignant tumors were identified in the series.
Conclusions:
- Germ cell damage in cryptorchidism appears established early and does not improve with delayed orchidopexy.
- Current data do not support a specific optimal timing for orchidopexy based on germ cell preservation.
- The findings highlight the irreversible nature of germ cell loss in cryptorchidism and question the timing of surgical intervention solely for this purpose.