Consequences of bilateral cryptorchidism in adults

Adomaitis, Robertas; Vincel, Beata; Eidukaitė, Audronė; Ostanevičiūtė, Elvyra; Kirka, R.; Bilius, Vytautas; Malcius, Dalius; Verkauskas, Gilvydas; Hadžiselimović, F.

doi:10.1111/and.12534

Cited by 13 publications

(10 citation statements)

References 28 publications

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“…The percentage of men participating in our study is 21.7% for the entire analysis. This is comparable to other studies ranging from 11.3% to 28.0% (Adomaitis, ; van Brakel, ; Trsinar, ). Several factors influence the response rate of long‐term studies like ours, generally negatively due to untraceable potential participants or outdated medical charts.…”

Section: Discussionsupporting

confidence: 92%

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Orchidopexy for bilateral undescended testes: A multicentre study on its effects on fertility and comparison of two fixation techniques

et al. 2018

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| INTRODUC TI ONBilateral undescended testes (BUDT) are associated with subfertility, which orchidopexy in early childhood aims to prevent. According to the literature, not treating BUDT results in azoospermia in 80% of men, whilst treatment reduces this to 7%-43% (Bellinger, 1989;Cendron, 1989;Cortes, 2001;Dadfar, 2007;Hoseinpour, 2015;Werder, 1976). Men with BUDT are less likely to father children. Only 62% will succeed within 12 months compared to 94% in healthy agematched controls (Lee, 1997). This lower fertility potential is also reflected in a decreased sperm concentration of 5.2 × 10 6 /ml in men with BUDT versus 82.4 × 10 6 /ml in controls (Lee, 1997).The technique for the preparation of the testis and the way to perform the fixation in the scrotum in relation to later fertility potential has not been thoroughly investigated. Animal studies have shown the presence of spermatogenesis in 71% of cases when using a suture through the tunica albuginea as fixation compared to 94% when using a tunica dartos pouch. Also, increased tubular atrophy was seen in 58% versus 23% respectively (Bellinger, 1989). The two techniques were evaluated for an effect on testicular volume in 69 AbstractTo evaluate fertility potential after orchidopexy for bilateral undescended testis and compare two surgical fixation techniques for effect on fertility. Men older than 22 years who had either tunica albuginea orchidopexy (TAO) or "no-touch" technique (NTO) in childhood for bilateral undescended testis (BUDT) were selected.Participants filled out a questionnaire followed by physical examination, had testicular ultrasound, blood sample and semen analysis. Statistical testing was performed using general linear modelling. Sixty-seven out of 166 individuals responded. Fortynine completed the questionnaire, and nine (18.3%) reported having fathered children. Thirty-six showed up for further examination, 26 had TAO and 10 NTO. Impaired hormonal spermatogenesis regulation (34.6% vs. 20%), higher subfertility rate (46% vs. 20%) and lower means of motile spermatozoa (58.1 × 10 6 spz vs.177.9 × 10 6 spz) were observed in the TAO versus the NTO group; none of these were statistically significant. Four (15.4%) of the TAO and two (20%) of the NTO group have azoospermia. Although the operation technique did not have a significant impact on fertility, unfavourable outcomes were more common after surgery involving the tunica albuginea of the testis. Larger sample sizes are needed to ascertain whether the trends favouring the NTO technique are of any significance. K E Y W O R D Sbilateral undescended testes, fertility, fixation technique, orchidopexy, semen analysis

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Section: Discussionsupporting

confidence: 92%

“…Compared to a previously published cohort of 1,300 military men, the men in our study seem to have significantly smaller testicles, with around half of the mean testicular volume (Bahk, ). The lower testicular volume in men with BUDT was also noted in earlier reports (Adomaitis, ; Lee, ).…”

Section: Discussionsupporting

confidence: 85%

Orchidopexy for bilateral undescended testes: A multicentre study on its effects on fertility and comparison of two fixation techniques

et al. 2018

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“…There was no correlation between age at correction of cryptorchidism and serum testosterone level (175). This is consistent with another study that found no correlation between age at orchiopexy and salivary testosterone level in men with a history of bilateral cryptorchidism (209). However, a study of unilateral cases in the US found an inverse correlation between age at orchiopexy and serum total testosterone level (210).…”

Section: Age At Treatmentsupporting

confidence: 84%

Hypogonadism and Cryptorchidism

et al. 2020

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Congenital cryptorchidism (undescended testis) is one of the most common congenital urogenital malformations in boys. Prevalence of cryptorchidism at birth among boys born with normal birth weight ranges from 1.8 to 8.4%. Cryptorchidism is associated with a risk of low semen quality and an increased risk of testicular germ cell tumors. Testicular hormones, androgens and insulin-like peptide 3 (INSL3), have an essential role in the process of testicular descent from intra-abdominal position into the scrotum in fetal life. This explains the increased prevalence of cryptorchidism among boys with diseases or syndromes associated with congenitally decreased secretion or action of androgens, such as patients with congenital hypogonadism and partial androgen insensitivity syndrome. There is evidence to support that cryptorchidism is associated with decreased testicular hormone production later in life. It has been shown that cryptorchidism impairs long-term Sertoli cell function, but may also affect Leydig cells. Germ cell loss taking place in the cryptorchid testis is proportional to the duration of the condition, and therefore early orchiopexy to bring the testis into the scrotum is the standard treatment. However, the evidence for benefits of early orchiopexy for testicular endocrine function is controversial. The hormonal treatments using human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) to induce testicular descent have low success rates, and therefore they are not recommended by the current guidelines for management of cryptorchidism. However, more research is needed to assess the effects of hormonal treatments during infancy on future male reproductive health.

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“…Hence, our results suggest an association between non-optimal birth characteristics and male factor infertility. One possible explanation of this association is that cryptorchidism, more common among children born with non-optimal birth characteristics, relates to lower sperm concentration and motility (Depue, 1984;Main et al, 2006;Hart et al, 2015;Adomaitis et al, 2016;Olesen et al, 2017). We do not, however, have data on how many men in this study were born with cryptorchidism.…”

Section: Discussionmentioning

confidence: 71%