title: Testicular biopsy in prepubertal boys: a worthwhile minor surgical procedure?
abstract: No consensus exists regarding the precise role of testicular biopsy in prepubertal boys, although it is considered useful for assessing the potential consequences of undescended testes on fertility. Current scientific knowledge indicates that surgeons should broaden indications for this procedure. For example, the use of immunohistochemical markers such as OCT/3-4, TSPY, Kit ligand (SCF) and ALPP (PLAP) has considerably facilitated the detection of germ cell tumour precursors, such as carcinoma in situ and/or gonadoblastoma. These markers are very important for evaluating malignancy risk in undervirilized patients with 46,XY disorders of sexual development. Testicular histology is also of considerable value in the prediction of both fertility potential and risk of cancer in individuals with undescended testes, particularly those with intraabdominal undescended testes. New possibilities for the preservation of fertility after gonadotoxic chemotherapy - even for prepubertal boys - are emerging. Cryopreservation of testicular tissue samples for the preservation of fertility - although still an experimental method at present - is appealing in this context. In our opinion, testicular biopsy in prepubertal boys is a minor procedure that can provide valuable information for predicting the risk of malignancy and fertility, and might be useful in fertility preservation in the near future.
authors.affiliation: Royal Children's Hospital, Department of Paediatric Urology, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
authors.forename: Alice
authors.initials: A
authors.lastname: Faure
authors.affiliation: Royal Children's Hospital, Department of Paediatric Urology, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
authors.forename: Aurore
authors.initials: A
authors.lastname: Bouty
authors.affiliation: Royal Children's Hospital, Department of Paediatric Urology, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
authors.forename: Mike
authors.initials: M
authors.lastname: O'Brien
authors.affiliation: Department of Paediatric Surgery, 9 Blegdamsvei, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Jorgen
authors.initials: J
authors.lastname: Thorup
authors.affiliation: Royal Children's Hospital, Department of Paediatric Urology, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Hutson
authors.affiliation: Royal Children's Hospital, Department of Paediatric Urology, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
authors.forename: Yves
authors.initials: Y
authors.lastname: Heloury
mesh_terms: D000367:Age Factors; D001706:Biopsy / Q000379:methods / Q000592:standards; D002648:Child; D002675:Child, Preschool; D059247:Fertility Preservation / Q000379:methods / Q000592:standards; D006801:Humans; D007248:Infertility, Male / Q000517:prevention & control; D008297:Male; D013511:Minor Surgical Procedures / Q000379:methods* / Q000592:standards; D013737:Testis / Q000473:pathology* / Q000601:surgery*