Long-term results of surgical treatment of cryptorchid boys. Part 2: Spermatogenetic and hormonal function
Article published in Urologia Polska 2005/58/1.
Wojciech Kuzański, Jerzy Niedzielski
- Klinika Chirurgii i Onkologii Dziecięcej Instytutu Pediatrii Uniwersytetu Medycznego w Łodzi
Kierownik kliniki: dr hab. Ewa Andrzejewska
testis, cryptorchism, spermogram
- aim of the study
- Testicular hormonal function and individual fertility potential was examined in cryptorchid men.
- material and methods
- 44 males (mean age 31 year 4.4) operated on due to cryptorchism; group I - 30 with unilateral, group II - 10 with bilateral defect, group III - 4 after orchiectomy. Serum levels of: testosterone, estradiol, FSH, LH, ß-inhibin, spermogram and oval motility index (OMI) were examined.
- Normospermia was found in 25, oligospermia in 10 and aspermia in 9 men. Normospermia was observed in 70% of patients of group I, in none of group II and in all instances in group III. The higher position of the testicle, the worse the spermogram was. Sperm cell number in group II was significantly worse than in group I. The OMI values were as follows: I: 18.36 14.85, II: 0.11 0.32, III: 23 10.23. A significant difference between OMI values in patients with abdominal and inguinal testicles was found. The OMI values were higher in patients treated by orchiopexy only compared to men previously treated with HCG surgery (12.32 15.31 vs. 8.81 12.63). 27 (61%) of 44 men remain in relationships declaring the will of having children; I: 19 (63%), II: 6 (60%), III: 2 (50%). 19 (70%) men had children: 16 after unilateral, one after bilateral orchiopexy, and two after orchiectomy.
- Bilateral cryptorchidism and primary abdominal testicle position appeared to have deteriorating influence on sperm quality, increasing FSH level and decreasing ß-inhibin serum concentration. The coexistence of both factors in one patient caused amplification of this effect.
- Kula K: Hipogonadyzm męski; w Pawlikowski M (red): Zaburzenia hormonalne, Warszawa, PZWL, 2003, wyd. I, 233-245.
- Szymkiewicz Cz, Baka-Jakubiak M: Niezstąpione jądro - wnętrostwo; w Semczuk M, Kurpisz M (red): Andrologia, Warszawa, PZWL, 1998, str. 247-252.
- Cunningham GR, Lipschutz LI: Diseases of the testes and male sex organs. In Clinical Endocrynology. P. O. Kohler ed, New York, John Wiley & Sons; 1986, Chapt 7, pp. 275-76
- Kula K: Hipogonadyzm męski; w Pawlikowski M (red): Zarys endokrynologii klinicznej Warszawa, PZWL, wyd. II, 1996, 1, 37-151.
- Kennedy WA, Snyder HM: Paediatric andrology: the impact of environmental pollutans. Br J Urol Int. 1999; 83, 195-200
- Cortes D: Cryptorchidism - aspects of pathogenesis, histology and treatment. Scand. J. Urol. Nephrol. Suppl. 1998; 196; 1-54.
- Thonneau PF, Candia P, Mieusset R: Cryptorchidism: Incidence, risk factors, and potential role of environment; an update. J Androl 2003; 24 (2); 155-62
- Marshall W. A., Tanner JM: Variations in the pattern of pubertal changes in boy. Arch Dis Child 1970; 45; 13-23
- World Health Organization: WHO laboratory manual for the examination of human semen and semen-cervical mucus interaction. 3th edn, The Press Syndicate of the University of Cambridge, USA, 1992.
- Guarino N, Tadini B, Bianchi M: The adolescent varicocele: the crucial role of hormonal tests in selecting patients with testicular dysfunction. J Pediatr Surg 2003; 38 (1); 120-123
- Vinardi S, Magro P, Manenti M et al: Testicular function in men treated in childhood for undescended testes. J Pediatr Surg 2001; 36 (2); 385-388
- Cortes D, Thorup J, Visfeldt J: Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism. J Urol 2000; 163; 1290-1292
- Hadziselimovic F, Herzog B, Buser M: Development of cryptorchid testes. Eur J Pediatr 1987; 146 (suppl. 2); 8-12
- Coughlin MT, O´Leary LA, Songer NJ, Bellinger MF, LaPorte RE, Lee PA: Time to conception after orchidopexy: evidence for subfertility? Fertil Steril. 1997; 67 (4); 742-746
- Lee PA, O´Leary LA, Songer NJ, Coughlin MT, Bellinger MF, LaPorte RE: Paternity after bilateral cryptorchidism. A controlled study. Arch Pediatr Adolesc Med 1997; 151 (3); 260-263.
- Miller KD, Coughlin MT, Lee PA: Fertility after unilateral cryptorchidism. Paternity, time to conception, pretreatment testicular location and size, hormone and sperm parameters. Horm Res 2001; 55 (5); 249-53.
- Lee PA, Coughlin MT: The single testis: paternity after presentation as unilateral cryptorchidism. J Urol 2002; 168 (4 Pt 2); 1680-1682.
- Lee PA, Coughlin MT: Fertility after bilateral cryptorchidism. Evaluation by paternity, hormone and semen data. Horm Res 2001; 55 (1); 28-32.
- Miodek M, Niedzielski J: Nieprawidłowości w budowie jądra, najądrza i nasieniowodu u chłopców z wnętrostwem. Urol Pol 2001; 54; 4; 63-66.
Klinika Chirurgii i Onkologii Dziecięcej
ul. Sporna 36/50
tel. (0... 42) 617 77 11, fax 617 77 05