Testicular biopsy in prepubertal boys: a worthwhile minor surgical procedure?

TY - JOUR

T1 - Testicular biopsy in prepubertal boys

T2 - a worthwhile minor surgical procedure?

AU - Faure, Alice

AU - Bouty, Aurore

AU - O'Brien, Mike

AU - Thorup, Jorgen

AU - Hutson, John

AU - Heloury, Yves

PY - 2016/3/1

Y1 - 2016/3/1

N2 - 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.

AB - 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.

KW - Age Factors

KW - Biopsy

KW - Child

KW - Child, Preschool

KW - Fertility Preservation

KW - Humans

KW - Infertility, Male

KW - Male

KW - Minor Surgical Procedures

KW - Testis

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

KW - Review

U2 - 10.1038/nrurol.2015.312

DO - 10.1038/nrurol.2015.312

M3 - Review

C2 - 26787392

SN - 1759-4812

VL - 13

SP - 141

EP - 150

JO - Nature Reviews. Urology

JF - Nature Reviews. Urology

IS - 3

ER -