A cross-sectional study of cryptorchidism in children: testicular volume and hormonal function at 18 years of age

Abstract

Purpose To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood.Materials and Methods Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism.Results Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 mL. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment.Bilateral cryptorchidism Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH.Conclusions Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or age of initial treatment exerts no definite effect on testicular volume improvement or hormonal levels at 18 years of age.

The volume of unilaterally undescended testis after hCG therapy compared to orchidopexy and combined methods

“…Moreover, all studied boys were prepubertal. Similar results were noted by Varela-Cives et al (2015), who evaluated TV in 18-year-old patients treated in childhood for unilateral or bilateral UDT. The initial median volume of the unilateral undescended testis before treatment was significantly lower in all examined groups (median TAI 13-33.4%).…”

“…The change in TV peaked 9 to 12 months after treatment. Similar results were noted by Varela-Cives et al (2015), who evaluated TV in 18-year-old patients treated in childhood for unilateral or bilateral UDT. The volume of the unilaterally undescended testis was significantly higher in patients who had undergone hCG treatment compared to those who had been operated on after failure of hormonal therapy and those who had undergone primary surgery.…”

“…We also observed that the affected testes grew the fastest in the first year after hCG therapy, but then their growth slowed. Similarly, Varela-Cives et al (2015) found that early À7 (À38 to 29) À3 (À52 to 37) À3 (À61 to 40) À12 (À52 to 27) TV (mL) affected testis 24-39 mo. after treatment (median, min-max) 0.89 (0.29-1.99) 1.00 ( À38 (À57 to 11) À10 (À51 to 17) À14 (À73 to 19) À16 (À30 to 1.2) TV, testicular volume; TAI, testicular atrophy index; N, number of patients; min, minimum; max, maximum; mo., months; change, change in TV and TAI with reference to values before treatment.…”

“…Dysgenetic testes are characterised by decreased volume, which has been attributed to poor development of testicular structure and a reduced number, or lack, of germ cells (Slowikowska-Hilczer et al, 2003, 2015. Varela-Cives et al (2015) report further development of both the undescended testis and a healthy scrotal counterpart in boys treated hormonally before two years of age compared to those treated after two years of age. At the 9-to 12-month time point, TV was found to be significantly higher following hCG administration than after surgical treatment or combined therapy.…”

“…A similar prevalence of testicular atrophy (5.3%) was observed in the ST group in the present study, while fewer were observed after combined therapy and none after hCG treatment. Varela-Cives et al (2015) report further development of both the undescended testis and a healthy scrotal counterpart in boys treated hormonally before two years of age compared to those treated after two years of age. The same phenomenon can be seen in the present study.…”