Inter/intra investigator variation in orchidometric measurements of testicular volume by ten investigators from five institutions

Tatsunami, Shinobu; Matsumiya, Kiyomi; Tsujimura, Akira; Itoh, Naoki; Sasao, Takumi; Koh, Eitetsu; Maeda, Yasuhiro; Eguchi, Jiro; Takehara, Kosuke; Nishida, Takayasu; Miyano, Satetsu; Tabata, Chisato; Iwamoto, Teruaki

doi:10.1111/j.1745-7262.2006.00143.x

Cited by 26 publications

(24 citation statements)

References 16 publications

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“…Boys tended to overestimate their genital development stage, while girls’ assessments were generally more highly correlated with physician reports (Table V), a pattern that has been observed in several previous studies (32, 53, 56). However, using physician assessment as the gold standard has the implicit assumption that it is without error when there is evidence that this assumption is weak (57–60). Another method of validating self-assessed sexual maturation status is comparing it with hormone-based measures of sexual maturation, although previous studies have been limited.…”

Section: Discussionmentioning

confidence: 99%

“…For example, substantial variation in assessments of skin fold thickness, waist circumference, and other anthropometry measures (63, 64), as well as blood pressure measurements (65–67) have been demonstrated. The reliability of physician assessed sexual maturation status has generally been poor, especially for assessment of testicular volume (58, 60) and breast development (57), and is highly dependent on appropriate training (59, 68). Our results further suggest that physician assessments are not free of error.…”

Section: Discussionmentioning

confidence: 99%

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Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

Chavarro

Watkins

Afeiche

et al. 2017

The Journal of Pediatrics

120

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Objective To compare self-report and physician assessments of sexual maturation against serum hormone markers to evaluate the hypothesis that the validity of self-assessed sexual maturation is underestimated in traditional validation studies. Study design We adapted a self-assessment instrument that 248 Mexican children and adolescents, age 8–13 years, completed. Participants were examined by a trained pediatrician and provided fasting blood samples for measurement of reproductive (testosterone, estradiol, sex hormone-binding globulin (SHBG), Inhibin B) and other hormones (C-peptide, insulin-like growth factor 1 (IGF-1), leptin, dehydroepiandrosterone sulfate (DHEA-S)) known to change during adolescence. Spearman correlations (r) were calculated among the average rank of all hormones, self-, and physician-assessed Tanner stage. The method of triads was used to assess validity of self-reports by estimating correlations between self-assessments and true, but unobservable, sexual maturation based on all available data. 95% confidence intervals (CI) were constructed using bootstrap sampling. Results Validity of self-reported genitalia staging for boys was modest (r[95%CI]=0.50[0.31–0.65]) and inferior to physician assessment (0.75[0.56–0.93]). Breast stage was well reported (0.89[0.79–0.97]) and superior to physician assessment (0.80[0.70–0.89]). Pubic hair stage reported by boys (0.91[0.79–0.99]) and girls (0.99[0.96–1.00]) were superior to physician assessment (0.79[0.57–0.97] and 0.91[0.83–0.97], respectively). Conclusion Self-assessment can be validly used in epidemiologic studies for evaluation of sexual maturation in children. Physician assessment may be necessary for accurate assessment of genitalia development in boys.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

Chavarro

Watkins

Afeiche

et al. 2017

The Journal of Pediatrics

120

View full text Add to dashboard Cite

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“…Currently, testicular volume can be assessed clinically by a variety of orchidometers, calipers and rulers or by US measurements of testis length, width and height, followed by multiplication by a constant. Although the orchidometer method is convenient for clinical use, experimental and clinical observations have shown that this method may not always be precise and consistent [10]. In fact, this method tends to overestimate the true volume, which might be caused by the inclusion of the epididymis or subcutaneous tissues [7,10,11].…”

Section: Discussionmentioning

confidence: 99%

The reliability of ultrasonographic measurements for testicular volume assessment: comparison of three common formulas with true testicular volume

Hsieh¹,

Huang²,

Huang³

et al. 2009

Asian J Androl

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The aim of this study was to determine the correlation of ultrasonographic estimates of testicular volume with true testicular volume and to compare the accuracy and precision of the three most commonly utilized formulas. A total of 15 patients underwent high-resolution ultrasonography (US) analysis for testicular volume before orchiectomy. Testicular volume was calculated using three common formulas: (1) All three US formula measurements significantly underestimated the true testicular volume. The largest mean biases were observed with US formula 1, which underestimated the true volume by 3.3 mL (31%). US formula 2 had a smaller mean difference from the true volume, with an underestimation of only 0.6 mL (6%). Regression analysis showed that formulas 1 and 2 had better R 2 values than formula 3. However, all three US formulas displayed a strong linear relationship with the true volume (R 2 = 0.872−0.977; P < 0.001). Among the commonly used US formulas, the empirical formula of Lambert (L × W × H × 0.71) provided better accuracy than the other two formulas evaluated, and better precision than formula 3. Therefore, the formula of Lambert is the optimal choice in clinical practice.

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“…An additional centrifuged semen sample was confirmed to be azoospermic on the day of the planned TESE. Testicular volume was measured by physical examination using a standardized orchidometer by a single surgeon 9 and the average volume of the two testes was used for analysis. If only one testis was present then it was used in the calculation.…”

Section: Methodsmentioning

confidence: 99%

Severe Testicular Atrophy does not Affect the Success of Microdissection Testicular Sperm Extraction

et al. 2014

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Introduction and Objectives Men with azoospermia and severe testicular atrophy may be counseled to avoid sperm retrieval due to perceived limited success. We evaluated the outcomes of microdissection testicular sperm extraction (micro-TESE) in men with severe testicular atrophy (volume ≤ 2 mL). Methods We reviewed the records of 1127 men with nonobstructive azoospermia who underwent micro-TESE followed by intracytoplasmic sperm injection. The men were classified into three groups based on average testicular volume (mL), ≤2, >2–10, >10. Sperm retrieval, clinical pregnancy, and live birth rates were calculated. The clinical features evaluated included age, FSH level, history of cryptorchidism, Klinefelter syndrome, varicocele, and testicular histology from diagnostic biopsy. Result(s) Testicular sperm were successfully retrieved in 56% of the men. Sperm retrieval rates (SRR) in men with testicular volumes of ≤ 2, >2–10, and >10 mL was 55%, 56% and 55% respectively. Of those men who had sperm retrieved, clinical pregnancy and live birth rates were similar in the three groups (55.2%, 50.0%, and 47.0%; and 47.2%, 43.0% and 42.2% respectively). Of the 106 men with average testis volume ≤ 2 mL bilaterally, men who had sperm retrieved were younger (31.1 vs. 35.2 years), and were more likely to have a history of Klinefelter syndrome (82.2% vs 55.6%) compared to those in whom sperm was not found (p < 0.05). Men in this group had a higher prevalence of Klinefelter syndrome than men with testis >2 mL (72.6% vs 5.3%, p<0.0001). Men younger than 30 years with Klinefelter syndrome had a higher SRR (81.8%) compared to men older than 30 without Klinefelter syndrome (33%, p<0.01). There was no cut-point for age beyond which sperm could not be retrieved in men with small testes. On multivariable analysis, younger age was the only preoperative factor associated with successful sperm retrieval in men with small testes (<2mL). Conclusion(s) Testicular volume does not affect sperm retrieval rates at our center with micro-TESE. For men with the smallest volume testes, those younger men with Klinefelter syndrome had the highest sperm retrieval rates. Severe testicular atrophy should not be a contraindication for micro-TESE.

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Inter/intra investigator variation in orchidometric measurements of testicular volume by ten investigators from five institutions

Cited by 26 publications

References 16 publications

Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

Validity of Self-Assessed Sexual Maturation Against Physician Assessments and Hormone Levels

The reliability of ultrasonographic measurements for testicular volume assessment: comparison of three common formulas with true testicular volume

Severe Testicular Atrophy does not Affect the Success of Microdissection Testicular Sperm Extraction

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