The Independent Functioning of the Orchidopexied Congenital Undescended Testis as Assessed by Positron Emission Tomography/Computed Tomography

Abstract

Fertility after orchidopexied undescended testes (UDT) is impaired. Although fertility parameters are known to be more favorable in unilateral cases than in bilateral cases, the exact contribution of the unilateral orchidopexied UDT to fertility is unknown. We used testicular 18F-fluoro-2-deoxyglucose (18F-FDG)-uptake assessed by positron emission tomography/computed tomography (PET/CT) to investigate the function of the orchidopexied unilateral congenital UDT, compared to its normally descended counterpart. We hypothesize that the contribution of the orchidopexied unilateral congenital UDT to fertility in adulthood is low. Eleven men who underwent orchidopexy for congenital UDT at the age of 1.9 ± 1.4 (range, 4.5 months -4.0) years were seen in follow-up at the age of 24.1 ± 2.3 (20.6-28.0) years. All underwent physical examination, testicular ultrasonography and PET/CT. Testicular 18F-FDG-uptake was expressed as the peak Standardized Uptake Value (SUVpeak). The mean SUVpeak of the orchidopexied UDT was 2.74 ± 0.48 (2.13-3.47), which was significantly lower than its counterpart (P = 0.021). Besides, there was no correlation between the testicular volume and the SUVpeak. The orchidopexied congenital UDT has been shown to be less metabolically active than its contralateral counterpart. Nevertheless, we suggest that the operated testes function to some degree.

18F‐FDG PET/CT use in functional assessment of the testes: A systematic review

“…Lastly, Meij-de Vries et al 32 reported that post-orchidopexy testes showed a statistically lower tracer uptake than the contralateral healthy testis. As it is known that testes post-orchidopexy show very low metabolic activity, the study findings suggested that the surgical procedure allows for some return of function into the affected testis.…”

“…Lastly, Meij‐de Vries et al 32 . reported that post‐orchidopexy testes showed a statistically lower tracer uptake than the contralateral healthy testis.…”

“…Study characteristics are outlined in Table 3. The study 32 which involved a population of patients who underwent a previous unilateral orchidopexy reported uptake results also of the unaffected contralateral testis in all patients. Hence, imaging results from the affected testes were classified into the benign group, while results of their 33 compared data of patients with malignant testicular disease against those with benign testicular pathology.…”