Adult orchidopexy: A survey on necessity of intraoperative testicular biopsy

Background: Cryptorchidism as the most prevalent congenital anomalies after birth is evident in more than 3% of live male newborns. The relative risk of neoplastic changes in undescended testes has been shown to be 40 times more in comparison to normal population. It is now believed that pre-malignant changes cannot be expected in undescended testes before puberty; therefore performing testicular biopsy while orchiopexy during pre-puberty has been gradually abandoned and its predictive value has become less valuable. Objectives: Studying intraoperative pathology samples of undescended testis (UDT) to determine the rate of their malignancies. Patients and Methods: From 2002 to 2006, we investigated pathology specimens of our patients including adults above 14 years old undergoing orchiopexy due to UDT at Kermanshah University Medical hospitals. Results: Studied population were 100 patients 14 to 45 years old with average age of 20.5 years, among them 52 persons had right UDT, 40 persons with left UDT and 8 persons with bilateral UDT.A total of 108 testes were studied. In 89 cases testicular atrophy proved to exist while not in the rest 11 ones. In 71 cases, testes were intracanalicular while in the other 37 cases were intra-abdominal. After studying the pathology results, no report of pre-malignant changes carcinoma in-situ status (CIS) was found in all 100 patients. Conclusions: The indication of doing testicular biopsy in adults suffering from UDT can be revised. Owing to no report of any malignancy in these cases, substitution of intraoperative testicular biopsy with long-time follow up can be utilized to reduce expenses and surgical trauma.