[Surgical indications in testicular ectopias]

The ideal age for treatment is still controversial. However, all recent histological studies show that the number of spermatogonia and the diameter of the tubules remain virtually normal until the beginning of the third year of life. Treatment therefore should take place in the second year, after all chances of spontaneous migration have vanished and before lesions due to cryptorchidism develop. Chorionic gonadotropic hormones should be used systematically; they avoid surgery in only one out of five cases, but they make it possible to test the possibilities of testicular descent and testosterone secretion. Surgical treatment should follow precise rules. The spermatic vessels might, if necessary, be severed, but care must be taken to preserve the gubernaculum. The alternative is, microsurgical autotransplantation. Only time will show whether the poor fertility of these patients is bettered by early treatment.