Dadfar Mohammad Reza
Department of Urology, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran.
Urol J. 2007 Summer;4(3):164-8.
Retractile testis may affect testicular parenchyma and spermatogenesis, and surgical treatment has been recommended for infertile men with retractile testes. We evaluated outcomes of orchidopexy in men with idiopathic infertility who suffered from bilateral retractile testes.
We performed dartos pouch orchidopexy on 22 men with idiopathic infertility and bilateral retractile testes. The patients were subsequently followed up for 1 year and sperm parameters were assessed at 3-month intervals. Testicular volume was determined by ultrasonography 1 year postoperatively and compared with that before orchidopexy. Satisfaction with the appearance of the external genitalia, sexual desire, and the ability to have successful intercourse were assessed through a Likert-scale questionnaire.
Before the operation, the mean testicular volume was 12.2 +/- 5.0% lower than the lower normal limit of the testis volume in adults, and no clinically significant change was observed 1 year after the operation. Sperm density showed no significant changes postoperatively, but the mean proportion of sperms with high-grade motility witnessed a significant increase 1 year after the operation (P = .007). The mean percentage of sperms with normal morphology had a significant decrease at 1 postoperative year. Significant improvements were reported in satisfaction with the appearance of the external genitalia, sexual desire, and successful intercourse 1 year after the operation.
Retractile testes might be at risk of growth retardation. We found that orchidopexy in retractile testes may improve sperm motility and increase fertility potential of the patients. We recommend orchidopexy in infertile men with bilateral retractile testes.
回缩性睾丸可能影响睾丸实质和精子发生,对于患有回缩性睾丸的不育男性,建议进行手术治疗。我们评估了患有双侧回缩性睾丸的特发性不育男性患者的睾丸固定术效果。
我们对22例患有特发性不育和双侧回缩性睾丸的男性患者进行了肉膜囊睾丸固定术。随后对患者进行了1年的随访,并每隔3个月评估一次精子参数。术后1年通过超声检查确定睾丸体积,并与睾丸固定术前进行比较。通过李克特量表问卷评估患者对生殖器外观、性欲以及成功性交能力的满意度。
手术前,平均睾丸体积比成人睾丸体积的正常下限低12.2 +/- 5.0%,术后1年未观察到临床显著变化。术后精子密度无显著变化,但术后1年,高活力精子的平均比例显著增加(P = .007)。术后1年,正常形态精子的平均百分比显著下降。术后1年,患者对生殖器外观、性欲和成功性交的满意度有显著提高。
回缩性睾丸可能有生长发育迟缓的风险。我们发现,回缩性睾丸的睾丸固定术可能会改善精子活力并增加患者的生育潜力。我们建议对患有双侧回缩性睾丸的不育男性进行睾丸固定术。