Crespo Chozas D, Alonso Blanco M, Yturriaga Matarranz R, Barrio Castellanos R
Servicio de Pediatría, Sección de Endocrinología, Hospital Ramón y Cajal, Madrid.
An Esp Pediatr. 1999 Jan;50(1):33-8.
Descent of the testes is essential for normal function, with cryptorchidism being associated with defective spermatogenesis. The postpubertal function of cryptorchid testicles seems to be related to the original location of the undescended testis and the age at the moment of treatment. The objective of this study was to evaluate the pubertal development and gonadal function in postpubertal patients treated for cryptorchidism during childhood.
Twenty postpubertal males with a mean age of 17.35 years (range: 15-21 years) and treated for cryptorchidism during childhood were evaluated for pubertal development and gonadal function. A hormonal study which included basal determinations of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), testicular volume assessed by Prader's orchidometer and semen analysis was performed on each patient.
Complete virilization was observed in all patients. The start and development of puberty were normal in all cases (except one patient that started puberty at 10 years of age). Basal studies in all patients showed normal levels of LH and testosterone. FSH levels were increased in 3 patients and normal in the other 17 patients. Fourteen patients achieved normal spermatogenesis with more than 20 million spermatozoa/ml. In the other 7 patients (35%), 5 with unilateral cryptorchidism and 2 with bilateral cryptorchidism, the sperm count remained below 20 million with a range of 0.8 to 18.4 x 10(6) spermatozoa/ml. The three males with elevated levels of FSH also presented oligospermia.
The results obtained show that pubertal development is normal after cryptorchidism. Impaired spermatogenesis is a major factor in undescended testes. Basal SH levels can be useful in predicting germinal damage secondary to cryptorchidism.
睾丸下降对于正常功能至关重要，隐睾症与精子发生缺陷相关。青春期后隐睾的功能似乎与未降睾丸的原始位置及治疗时的年龄有关。本研究的目的是评估儿童期接受隐睾症治疗的青春期后患者的青春期发育及性腺功能。
对20名青春期后男性进行评估，他们童年期接受过隐睾症治疗，平均年龄17.35岁（范围：15 - 21岁），评估内容包括青春期发育及性腺功能。对每位患者进行了一项激素研究，包括基础睾酮、黄体生成素（LH）和卵泡刺激素（FSH）测定，用普拉德睾丸计评估睾丸体积并进行精液分析。
所有患者均出现完全男性化。所有病例（除1例10岁开始青春期发育的患者外）青春期的启动及发育均正常。所有患者的基础研究显示LH和睾酮水平正常。3例患者FSH水平升高，另外17例患者正常。14例患者精子发生正常，精子浓度超过2000万/ml。另外7例患者（35%），5例单侧隐睾和2例双侧隐睾，精子计数低于2000万，范围为0.8至18.4×10⁶/ml。FSH水平升高的3名男性也存在少精子症。
所得结果表明隐睾症后青春期发育正常。精子发生受损是未降睾丸的一个主要因素。基础SH水平有助于预测隐睾症继发的生精损害。
