OBJECTIVETo investigate the sexual development in adolescents after surgical treatment for undescended testes.

METHODSOne hundred and eighty-four adolescents undergoing surgery for cryptorchidism before the age of 10 years, 22 cases received no surgical management for unilateral undescended testes, and 25 normal controls were studied. The pubic stage, the natural length and girth of the penis, the volume of the testis, serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone (T) were examined to find out the effect of age, the location of the testis and operative procedures on prognosis.

RESULTSThe pubic stage, the length and girth of the penis, the volume of the testis and T decreased, but FSH and LH increased significantly in 18 adolescents who had undergone bilateral orchiopexy. The volume of the unilaterally undescended testis was significantly smaller than that of the normally descended contralateral gonad in 152 adolescents who had undergone unilateral orchiopexy. FSH was significantly higher in the adolescents surgically treated for unilateral cryptorchidism. Those treated by unilateral orchiectomy presented significantly higher levels of FSH than those by unilateral orchiopexy. The pubic stage, the length and girth of the penis, the volume of the testis and T were significantly higher, but FSH lower in the adolescents treated before the age of 5 years than at the age of 5 or older. The decrease in testicular volume was significantly greater in adolescents with intra-abdominal testes. Significant negative correlation was found between FSH and testicular volume.

CONCLUSIONLeydig cell function seems relatively resistant to the hostile environment of the cryptorchidism. Early diagnosis and management of the undescended testis are needed to preserve fertility.