Male with history of bilateral undescended testis

Male with bilateral undescended testis (especially intra-abdominal testes) are usually sterile. To optimise spermatogenesis the testis needs to be in the scrotum below body temperature at a young age. Incompletely descended testes are often macroscopically normal in early childhood but by pubey the testis is poorly developed, gradually atrophies. The epithelial elements are immature histologically and by late pubey irreversible destructive changes halt spermatogenesis and limit the production of androgens leading to sterility.Malignant transformation in undescended testis is 20 times more common than normally descended testis. Pathophysiology include gubernacular dysfunction, lack of gonadotrophin, lack of 'calcitonin gene related peptide'(CGRP) , familial , altered hypothalamo-pituitary-gonadal axis, deficiency of mullerian inhibiting substance, Prune-Belly syndrome. These patients also require psychological intervention. Reference : page77 and 1377 Bailey and Love's sho practice of surgery 25th edition and page1079 SRB's manual of surgery 5th edition