Long-Term Testicular Growth and Position after Orchidopexy for Congenital Undescended Testis

Sijstermans, K.; Hack, W. W. M.; Voort-Doedens, L.M. van der; Meijer, R. W.

doi:10.1159/000251185

Cited by 17 publications

(14 citation statements)

References 44 publications

(24 reference statements)

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“…In all 12 cases, the testes retained their scrotal position after 12 months of follow-up, and had a good size when compared to the contralateral normally descended one, by clinical examination. We considered a postoperative testicular volume of >50% on the operated side to be the least acceptable as a good outcome, which is in keeping with the published literature [18][19][20]. Ultrasonographically, we found the relative/differential testicular volume (operated UDT volume divided by the contralateral normal testis volume) to have a mean ratio (±SD) of 0.78 (±0.12) and a median ratio (range) of 0.8 (0.6-0.9) [18].…”

Section: Resultssupporting

confidence: 68%

Unsatisfactory testicular position after inguinal orchidopexy: Is there a role for upfront laparoscopy?

Youssef

Marei

Abou-Elfadl

et al. 2019

Arab Journal of Urology

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Objectives: To examine the role of laparoscopy in managing unsatisfactory testicular position after an open inguinal orchidopexy. We hypothesised that testes that were originally peeping, where short vessels represented a difficulty and testes that only reached a high scrotal position under tension, especially after an initial surgery performed with the appropriate expertise, are candidates for initial laparoscopic dissection. Patients and methods: Nineteen boys with an initial open inguinal orchidopexy, with a mean age of 31 months, were considered. Twelve were then treated by a laparoscopic-assisted orchidopexy technique. Standard laparoscopy was established and utilised to mobilise the spermatic cord from above, then completed by an open inguinal mobilisation. Results: The mean age at surgery was 26 months. The laparoscopic redo surgery took place at a mean interval of 11.9 months after the initial operation. The mean operative time was 72 min. A good position and size of the testis were achieved in all cases, evidenced by ultrasonography at 6 months postoperatively and clinically thereafter. Conclusion: An upfront combined laparoscopic and inguinal approach to redo orchidopexy for recurrent palpable undescended testes is suitable in selected patients. This study identifies the selection criteria and outlines the operative considerations. This laparoscopic-assisted approach is a safe and feasible way to correct unsatisfactory position of the testis, with diminished risk of injury to the vas and vessels, while gaining the maximum possible length by high retroperitoneal dissection.

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Section: Resultssupporting

confidence: 68%

Unsatisfactory testicular position after inguinal orchidopexy: Is there a role for upfront laparoscopy?

Youssef

Marei

Abou-Elfadl

et al. 2019

Arab Journal of Urology

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“…The salivary test is acceptable for screening purposes, but evaluation of gonadotropins as well as testosterone in the blood is clearly necessary for making treatment decisions in men with a history of bilateral cryptorchidism (Morley et al ., ). Testicular volume correlated positively with a total sperm count in our patients, suggesting that the measurement of testicular volume by ultrasound or orchidometer is a valuable tool (Sijstermans et al ., ).…”

Section: Discussionmentioning

confidence: 97%

Consequences of bilateral cryptorchidism in adults

et al. 2016

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Bilateral cryptorchidism treatment results are often shadowed by the majority of unilateral cases. We report the long-term follow-up results of boys treated for bilateral cryptorchidism during childhood. Patients treated in two main paediatric surgery centres were selected from medical registries and invited for a clinical examination including scrotal ultrasound, salivary testosterone measurement and a semen sample. Thirty-six men (38.3%) replied to the written invitation, and 21 agreed to be examined. The mean age at orchidopexy was 74 months (range 24-138). Sperm count was 0.42 × 10 (SD ± 0.64 × 10 ) ml . The correlation between total testicular volume and total sperm count was statistically significant (r = 0.481; P = 0.032). These results show that surgical treatment of bilateral cryptorchidism after the age of 2 years does not prevent infertility. Sperm count and endocrine evaluation advocated after the treatment of bilateral cryptorchidism in all adult patients.

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“…Undescended testes exposed to a high temperature are likely to complete spermatogenic failure in that decreases in sperm count and motility are developed [25,26,27], albeit testicular volume is not affected [28]. Early orchidopexy is proposed to prevent morphological changes in undescended testes and can improve fertile outcome [3,24,29].…”

Section: Discussionmentioning

confidence: 99%

Cryptorchidism Is Not a Risk Factor for Antisperm Antibody Production in Post-Orchidopexy Males with Infertility

Jiang

Zhu²

2013

Urol Int

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Introduction: Infertility in adulthood is a well-recognized consequence of cryptorchidism, even after successful orchidopexy. Autoimmune reactions against spermatozoa are associated with infertility and often found in cryptorchids. The purposes of this study were to evaluate the linkage between antisperm antibody (ASA) and cryptorchidism, and furthermore, to clarify whether ASA is involved in cryptorchidism-associated infertility. Materials and Methods: We investigated a total of 48 infertile males with a history of unilateral (n = 30) or bilateral (n = 18) cryptorchidism who had undergone successful orchidopexy in prepuberty, and 20 age-matched fertile and healthy males were collected as controls. ASA in sperm samples was detected by the direct immunobead test, and semen analysis was performed concomitantly. Results: No infertile case satisfied the diagnostic criteria of ASA-mediated infertility set forth by the World Health Organization. Decreases in both sperm concentration and motility accompanied by increases in abnormal morphology were seen in infertile cryptorchids when compared with the healthy controls. Conclusions: Testicular heat exposure in prepuberty is not a risk factor for ASA production. It is evident that the mechanisms that underlie cryptorchidism-associated infertility do not involve ASA. Poor sperm characteristics in cryptorchids resulting from thermal damage to the testes seem to be responsible for their infertility, even after successful orchidopexy.

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Long-Term Testicular Growth and Position after Orchidopexy for Congenital Undescended Testis

Cited by 17 publications

References 44 publications

Unsatisfactory testicular position after inguinal orchidopexy: Is there a role for upfront laparoscopy?

Unsatisfactory testicular position after inguinal orchidopexy: Is there a role for upfront laparoscopy?

Consequences of bilateral cryptorchidism in adults

Cryptorchidism Is Not a Risk Factor for Antisperm Antibody Production in Post-Orchidopexy Males with Infertility

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