The Effect of Two‐stage Orchiopexy on Testicular Growth

Corbally, Martin; Quinn, Feargal; Guiney, E. J.

doi:10.1111/j.1464-410x.1993.tb00737.x

Cited by 11 publications

(6 citation statements)

References 9 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, can it be considered as normal if the testis reveals normal or mild decreased volume after SVCD procedure? It has been observed that 40% of the testes were atrophied and 48% were volume decreased in addition after two-staged orchidopexy [19], in which the authors did not confirm whether the decreased volume of testes was considered to be atrophy. In the present study, apart from the atrophic testes with evident size reduction, only 15% SVCD testes showed normal histology; 34% SVCD testes revealed normal or mild size reduction, but evidently decreased ST area and Johnsen score with partial (24%) or severe (10%) impaired spermatogenesis from peripuberty to middle age.…”

Section: Discussionmentioning

confidence: 92%

Effects of laparoscopic division of spermatic vessels on histological changes of testes: long-term observation in the model of prepubertal rat

Tang

Gorgas²,

Zachariou

2007

Pediatr Surg Int

View full text Add to dashboard Cite

Laparoscopic Fowler-Stephens and Palomo procedures are now commonly performed in children with high positioned intra-abdominal cryptorchidism and varicocele, respectively. During the procedures, the spermatic vessels are ligated and therefore the question of risk related to testicular atrophy is often raised. The long-term follow-up of the histology after the procedures is rare. In this study, we simulated a laparoscopic spermatic vessels clipping and division (SVCD) in a prepubertal rat model, and examined the histological alterations of the testes with regard to spermatogenic arrest between prepuberty and middle age. Thirty-day-old Wistar rats divided randomly into three groups underwent laparoscopic sham operation, unilateral SVCD and unilateral SVCD with additional contralateral orchiectomy, respectively. Histological investigations observed on semithin and paraffin sections were performed at seven different postoperative intervals between day 9 and day 540. We defined partial, most and complete spermatogenic arrest of the seminiferous tubules to correspond with mild, severe spermatogenic arrest and atrophy, respectively. Laparoscopic SVCD induced testicular spermatogenic arrest in a total of 85% of the operated testes with different severity; 27% of operated testes with mild or severe spermatogenic arrest were seen between puberty and middle age (day 45-540 postoperative), and their size was only slightly reduced. Of the operated testes, 51% showed atrophic signs with a striking decrease in size, and their contralateral testes revealed in all cases mild or severe spermatogenic arrest started as early as day 45 postoperatively. Parallel to the spermatogenic arrest, Leydig cell hyperplasia developed frequently in impaired testes, especially in those without contralateral testes, finally reaching a typical adenoma size. Laparoscopic SVCD in prepubertal rats could disturb spermatogenesis with differing severity in most cases. This impairment could persist from peripuberty to middle age, and even involve the contralateral testes, in the case of operated testes and show complete spermatogenic arrest. This study showed that laparoscopic SVCD may have high risk in compromising the operated testis.

show abstract

Section: Discussionmentioning

confidence: 92%

Effects of laparoscopic division of spermatic vessels on histological changes of testes: long-term observation in the model of prepubertal rat

Tang

Gorgas²,

Zachariou

2007

Pediatr Surg Int

View full text Add to dashboard Cite

show abstract

“…Staged orchidopexy was an option considered previously in high inguinal testis [8]. However, it was associated with a high rate of testicular atrophy in up to 40% of the cases [9].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic mobilization of testicular vessels: an adjunctive step in orchidopexy for impalpable and redo undescended testis in children

et al. 2005

View full text Add to dashboard Cite

The testicular position after conventional inguinal orchidopexy for canalicular, "peeping" and redo undescended testes may not be satisfactory despite retroperitoneal dissection. Laparoscopy allows extensive mobilization of testicular vessels to gain additional length. We review our experience of using laparoscopic mobilization of testicular vessels (LMTV) in orchidopexy for these difficult undescended testes. From January 2003 to May 2004, LMTV was performed in 18 boys. The testicular vessels were mobilized from just proximal to the internal inguinal ring to the level of caecum and sigmoid colon respectively. Fifteen patients had clinically impalpable testes. Diagnostic laparoscopy revealed 13 "peeping" and 2 canalicular testes. LMTV was performed together with inguinal orchidopexy. There were three cases of redo orchidopexies because of unfavourable testicular position after previous surgery. LMTV was performed following inguinal dissection. The median follow-up period is 11.7 months. Sixteen testes are located at the base of scrotum, and two at mid-scrotum. The size is normal in 17 testes, whereas 1 testis is smaller than the contralateral one. LMTV is a safe and efficient adjunctive step in orchidopexy for impalpable and redo undescended testes.

show abstract

“…Also higher rates of postoperative atrophy, up to 40%, have been reported, but these were associated with staged orchidopexies [84, 85]. Thus, nonpalpable testes are at a higher risk of being damaged than palpable ones.…”

Section: Untoward Effects Of the Treatmentmentioning

confidence: 99%

Maldescendus testis

Toppari¹,

Kaleva²

1999

Horm Res Paediatr

View full text Add to dashboard Cite

Maldescendus testis is a common congenital abnormality occurring in 2–5% of full-term boys at birth in the Western countries. By 3 months of age, the incidence rate spontaneously reduces to 1–2% in this group. The etiology of the disorder is not known, but normal hypothalamo-pituitary-gonadal axis is usually a prerequisite for normal descent of the testes. Abnormal sexual differentiation is associated with maldescent. However, the majority of boys with maldescended testes show no endocrine abnormalities after birth. Several defects in developmental genes, such as homeobox genes and Insl3, have been described to cause cryptorchidism in mice, and disturbances in the regulation of these genes or their mutations may explain etiology of a large part of human testicular maldescent in the future. Increased degeneration of germ cells can be observed in undescended testes after the first year, and therefore early treatment is recommended. Surgical treatment is the most effective and reliable method to bring testes into the scrotum, but hormone treatment with either hCG or GnRH analogues can be considered, particularly in cases where testes can be palpated in high scrotal position. The efficacy of hormone treatment is less than 20% and depends on the initial location of the testis. Nonpalpable testes rarely descend with hormone treatment. Both surgery and hormone treatment can have untoward effects. Treatment with hCG has been associated with an inflammation-like reaction in the testes and an increased rate of apoptosis of germ cells leading to a reduced adult size of the testes. Vascular complications can occur during surgery, particularly in staged orchidopexies. Men with a history of undescended testis have an increased risk of testicular cancer. Impaired fertility is another long-term risk associated to maldescended testes. Fertility potential may be improved by early treatment. Although our knowledge on cryptorchidism has increased considerably during the last decades, many questions remain to be answered: Is the incidence rate increasing? What is causing maldescent? Do hormones have any role in the treatment?

show abstract

The Effect of Two‐stage Orchiopexy on Testicular Growth

Cited by 11 publications

References 9 publications

Effects of laparoscopic division of spermatic vessels on histological changes of testes: long-term observation in the model of prepubertal rat

Effects of laparoscopic division of spermatic vessels on histological changes of testes: long-term observation in the model of prepubertal rat

Laparoscopic mobilization of testicular vessels: an adjunctive step in orchidopexy for impalpable and redo undescended testis in children

Maldescendus testis

Contact Info

Product

Resources

About