Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Urology. 2011 Oct;78(4):886-9. doi: 10.1016/j.urology.2011.04.057. Epub 2011 Jul 18.
To compare the long-term follow-up growth of congenital, unilaterally palpable, undescended testes after orchiopexy according to age at the time of surgery. The optimal age for surgical treatment remains controversial.
A total of 86 patients (108 testes) between the ages of 1 and 9 years underwent orchiopexy. Patients were divided according to age at the time of surgery: group I, <2 years (n = 43); group II, 2 ≤ age < 5 years (n = 35); and group III, ≥5 years (n = 30). The boys were then followed for more than 2 years after surgery. Ultrasonography was used for determination of testicular volume. Testicular volume percentage was compared by the equation of (operated testis volume/normal testis volume × 100%).
Testicular location was the inguinal canal in 92 (85.2%) and lower to the external inguinal ring in 16 (14.8%). Only group I, which received orchiopexy within two years from birth, showed significant recovery of testicular volume at follow-up (P <.05), compared with groups II and III.
Orchiopexy performed at less than 2 years from birth was a significant factor for recovery of delayed cryptorchid testicular growth. This result suggests that early orchiopexy improves subsequent testicular catch-up growth.
比较手术时年龄不同的先天性单侧可触及未降睾丸行睾丸固定术后的长期随访生长情况。手术治疗的最佳年龄仍存在争议。
共 86 例(108 个睾丸)1 至 9 岁的患者接受了睾丸固定术。根据手术时的年龄将患者分为三组:I 组,<2 岁(n=43);II 组,2≤年龄<5 岁(n=35);III 组,≥5 岁(n=30)。手术后,男孩的随访时间超过 2 年。采用超声检查确定睾丸体积。睾丸体积百分比通过公式(手术睾丸体积/正常睾丸体积×100%)进行比较。
睾丸位置为腹股沟管 92 例(85.2%),外环下方 16 例(14.8%)。只有 I 组(出生后 2 年内接受睾丸固定术)在随访时睾丸体积有显著恢复(P<.05),与 II 组和 III 组相比。
出生后 2 年内进行睾丸固定术是恢复隐睾睾丸生长延迟的重要因素。这一结果表明早期睾丸固定术可促进随后的睾丸追赶生长。