Koff W J, Scaletscky R
Servico de Urologia, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil.
J Urol. 1990 Feb;143(2):340-3. doi: 10.1016/s0022-5347(17)39954-8.
Epididymal abnormalities in undescended testes are probably more common than suggested in the literature but only sporadic reports are found on this subject. For many years discussions have centered around the ideal age to operate on patients with undescended testes and consequently increase chances for future fertility. We analyzed 66 patients (82 testes) treated for undescended testis in our department, with special distinction between ectopia and cryptorchidism. Abnormalities ranged from simple epididymal elongation to more complex forms, such as complete disruption between the testis and epididymis. Among 49 ectopic testes the epididymides of 19 (38.8%) displayed more severe abnormalities in addition to elongation, while 16 (32.6%) showed only an elongated epididymis and 14 (28.6%) were normal. Among the 33 cryptorchid testes 29 (87.9%) showed the more complex anomalies and elongation, 3 (9.1%) were normal and only 1 (3%) was elongated. Our results demonstrate a much higher incidence of complex epididymal abnormalities in cryptorchidism (p less than 0.001). Elongated epididymis may present problems for sperm maturation and transportation, although with no other associated abnormality most can be regarded as patent. In our theory cases of elongation plus other major abnormalities probably are associated with severe impairment in sperm maturation and hindered transportation, with the future intrascrotal or extrascrotal position of the testis or early surgical repair being of little importance in terms of fertility.
隐睾患者的附睾异常可能比文献中所提示的更为常见，但关于这一主题仅有零星报道。多年来，讨论主要集中在对隐睾患者进行手术的理想年龄，从而提高未来生育的几率。我们分析了在我院接受隐睾治疗的66例患者（82个睾丸），特别区分了睾丸异位和隐睾。异常情况从简单的附睾延长到更复杂的形式，如睾丸与附睾之间完全中断。在49个异位睾丸中，19个（38.8%）的附睾除延长外还表现出更严重的异常，而16个（32.6%）仅显示附睾延长，14个（28.6%）正常。在33个隐睾中，29个（87.9%）表现出更复杂的异常和延长，3个（9.1%）正常，只有1个（3%）延长。我们的结果表明隐睾中复杂附睾异常的发生率要高得多（p小于0.001）。附睾延长可能会给精子成熟和运输带来问题，尽管没有其他相关异常，大多数仍可视为通畅。根据我们的理论，附睾延长加其他主要异常的病例可能与精子成熟严重受损和运输受阻有关，就生育能力而言，睾丸未来位于阴囊内或阴囊外的位置或早期手术修复意义不大。
