Department of Urology, Gulhane Military Medical Academy, 06018, Ankara, Turkey.
Int Urol Nephrol. 2012 Dec;44(6):1617-22. doi: 10.1007/s11255-012-0256-3. Epub 2012 Aug 5.
The main objectives of this retrospective cohort study were to evaluate reproductive endocrine and semen profiles before and after simple orchiectomy in patients with unilateral postpubertal cryptorchidism and to investigate the relationship between hormone levels and histopathology of the removed testis.
We evaluated 40 adult males who were admitted to our clinic, between 2001 and 2007, with unilateral undescended testis. Right orchiectomy was performed in 27 patients and left orchiectomy in 13. Semen analysis, serum inhibin B, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels were examined in before and 3 months after orchiectomy. Orchiectomy materials were evaluated histopathologically.
Semen parameters, as well as testosterone and LH levels, did not change in any histopathological subgroups in the postoperative follow-up. In patients with maturation arrest, mean serum inhibin B level statistically significantly decreased from 160.9 to 83.5 pg/ml, and mean FSH level significantly increased from 4.8 to 7.6 mIU/ml after orchiectomy (p value, 0.008 and 0.008, respectively). Though, the levels were still within the normal range of the two hormones.
Simple orchiectomy does not have any effect on semen parameters and testosterone level in patients with postpubertal cryptorchidism. The change in inhibin B and FSH levels after orchiectomy in patients with maturation arrest is not clinically significant.
本回顾性队列研究的主要目的是评估单侧青春期隐睾症患者行单纯睾丸切除术前后的生殖内分泌和精液特征,并探讨激素水平与切除睾丸组织病理学之间的关系。
我们评估了 2001 年至 2007 年间因单侧未降睾丸而就诊于我院的 40 例成年男性患者。27 例患者行右侧睾丸切除术,13 例患者行左侧睾丸切除术。分别在术前和术后 3 个月检测精液分析、血清抑制素 B、卵泡刺激素(FSH)、黄体生成素(LH)和睾酮水平。对睾丸切除术标本进行组织病理学评估。
在术后随访中,各组织病理学亚组的精液参数以及睾酮和 LH 水平均无变化。在精母细胞发育停滞患者中,血清抑制素 B 水平从 160.9 降至 83.5pg/ml,FSH 水平从 4.8 升至 7.6mIU/ml,差异均有统计学意义(p 值分别为 0.008 和 0.008)。尽管如此,这两种激素的水平仍在正常范围内。
对于青春期隐睾症患者,单纯睾丸切除术对精液参数和睾酮水平均无影响。精母细胞发育停滞患者行睾丸切除术前后抑制素 B 和 FSH 水平的变化无临床意义。