Coughlin M T, Bellinger M F, Lee P A
Department of Pediatrics, University of Pittsburgh School of Medicine, Pennsylvania, USA.
J Urol. 1999 Sep;162(3 Pt 2):986-8; discussion 989. doi: 10.1016/S0022-5347(01)68040-6.
We determined whether there are differences in hormone levels, such as inhibin B, follicle-stimulating hormone (FSH), luteinizing hormone and testosterone, and sperm density in men with a history of unilateral cryptorchidism as stratified by age at orchiopexy.
A total of 84 men with a history of unilateral cryptorchidism presented to our institution for serum hormone measurement and semen analysis. These parameters were compared using Pearson's correlations and analysis of variance among 4 groups stratified according to age at orchiopexy (range 1 month to 11 years).
Comparison by Pearson's correlation analysis showed that age at orchiopexy significantly correlated inversely with inhibin B (r = -0.274, p = 0.012) and positively correlated with FSH (r = 0.229, p = 0.036). Comparison of mean hormone levels and sperm density by analysis of variance for linear trend revealed a significant relationship between age at surgery with inhibin B (p = 0.032) and testosterone (p = 0.029), while sperm density, FSH and luteinizing hormone were not significantly related. Post hoc comparison of individual means at surgery and at the time of this study demonstrated a significantly higher inhibin B level in the youngest age group than in 2 of the 3 older groups.
Men who previously had unilateral cryptorchidism and who underwent orchiopexy by age 2 years have higher inhibin B and lower FSH profiles than those who underwent surgery later in life. This finding suggests an overall beneficial effect of early orchiopexy in boys born with unilateral cryptorchidism.
我们确定了既往有单侧隐睾病史的男性,根据睾丸固定术时的年龄分层,其激素水平(如抑制素B、促卵泡生成素(FSH)、促黄体生成素和睾酮)及精子密度是否存在差异。
共有84例有单侧隐睾病史的男性到我们机构进行血清激素测定和精液分析。使用Pearson相关性分析及方差分析,对根据睾丸固定术时年龄(范围1个月至11岁)分层的4组患者的这些参数进行比较。
Pearson相关性分析显示,睾丸固定术时的年龄与抑制素B呈显著负相关(r = -0.274,p = 0.012),与FSH呈正相关(r = 0.229,p = 0.036)。通过线性趋势方差分析比较平均激素水平和精子密度,结果显示手术时年龄与抑制素B(p = 0.032)和睾酮(p = 0.029)之间存在显著关系,而精子密度、FSH和促黄体生成素无显著相关性。对手术时及本研究时的个体均值进行事后比较发现,最年轻年龄组的抑制素B水平显著高于其他3个年龄组中的2个。
既往有单侧隐睾病史且在2岁前接受睾丸固定术的男性,其抑制素B水平较高,FSH水平较低,高于那些在生命后期接受手术的男性。这一发现提示早期睾丸固定术对单侧隐睾患儿具有总体有益作用。