Undescended testes and puberty. Orchidopexia or orchiectomy.

In 35 consecutive patients who were over 11 years of age, surgical exploration was preformed for unilateral undescended testes. To evaluate the quality of spermatogenesis all testes were biopsied. In two patients with macroscopically normal testes a malignancy was detected, one seminoma and one carcinoma in situ with micro-infiltrative carcinoma. In all patients considerable loss of spermatogenesis could be demonstrated and in all but three patients severe degenerative changes were present. On the basis of this study we would consider orchiectomy rather than orchidopexia in patients with unilateral undescended testes presenting at puberty or later.