ADULT DARK SPERMATOGONIA AND FERTILITY POTENTIAL IN CRYPTORCHID TESTES 1571

testes of human fetuses, neonates and infants. JUrol 1995; 154: 1188.

11. Thorup J, Cortes D and Nielsen OH: Clinical andhistopathologie evaluation of operated malde-scended testes after luteinizing hormone-releasinghormone treatment. Pediatr Surg Int 1993; 8: 419.

12. Hadziselimovic F, Zivkovic D, Bica DT et al:The importance of mini-puberty for fertility incryptorchidism. J Urol 2005; 174: 1536.

13. Hadziselimovic F, Emmonsa LR and Buser MW: Adiminished postnatal surge of Ad spermatogoniain cryptorchid infants is additional evidence forhypogonadotropic hypogonadism. Swiss MedWkly 2004; 134: 381.

14. Jørgensen N, Rajpert-De Meyts E, Graem N et al:Expression of immunohistochemical markers fortesticular carcinoma in situ by normal humanfetal germ cells. Lab Invest 1995; 72: 223.

15. Hutson JM, Li R, Southwell BR et al: Germ celldevelopment in the postnatal testis: the key toprevent malignancy in cryptorchidism? FrontEndocrinol 2013; 3: 176.

16. Hadziselimovic F and Herzog B: Hodendystopie.In: Kinderurologie in Klinik und Praxis,2nd ed. Edited by JW Th€uroff and H Schulte-Wissermann. New York: Thieme 2000;pp 484e500.

17. Rusnack SL, Wu HY, Huff DS et al: Testis histo-pathology in boys with cryptorchidism correlates

with future fertility potential. J Urol 2003; 169:659.

18. Kraft KH, Canning DA, Snyder HM et al: Unde-scended testis histology correlation with adulthormone levels and semen analysis. J Urol 2012;188: 1429.

19. Cortes D: Editorial comment: Undescendedtestis histology correlation with adult hormonelevels and semen analysis. J Urol 2012; 188:1435.

20. Mieusset R, Fonda PJ, Vaysse P et al: Increase intesticular temperature in case of cryptorchidismin boys. Fertil Steril 1993; 59: 1319.

EDITORIAL COMMENT

Testicular biopsies have implicated a decreased germ (reference 18 in article). Nonetheless, these results

cell count as the histological basis of subfertility inpatients with undescended testes. The authorsconvincingly report that the presence and number ofPLAP positive germ cells should be consideredadditional histological parameters when assessingfertility potential in bilateral cryptorchidism cases.Including adult hormone levels, semen analysis orpaternity data in this cohort would further clarifythe clinical relevance of these findings, particularlysince associations between germ cell histology andthese variables suggest that testicular biopsy atbilateral orchiopexy may help predict future fertility

underscore the value of reviewing testis histology inpatients with bilateral cryptorchidism when coun-seling families about fertility potential. Furtherinvestigation is warranted to determine whethertesticular biopsy at bilateral orchiopexy should beroutine clinical practice for detecting boys at risk forfuture infertility.

Kate H. KraftDepartment of Urology

University of Michigan Health System

Ann Arbor, Michigan