Varela-Cives R, Mendez-Gallart R, Estevez-Martinez E, Rodriguez-Barca P, Bautista-Casasnovas A, Pombo-Arias M, Tojo-Sierra R
Department of Pediatric Surgery & Urology, University Hospital of Santiago, Santiago de Compostela, Spain.
Department of Pediatrics, University Hospital of Santiago, Santiago de Compostela, Spain.
Int Braz J Urol. 2015 Jan-Feb;41(1):57-66. doi: 10.1590/S1677-5538.IBJU.2015.01.09.
To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood.
Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism.
Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 L. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment. Bilateral cryptorchidism: Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH.
Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or age of initial treatment exerts no definite effect on testicular volume improvement r hormonal levels at 18 years of age.
评估童年期诊断并治疗的隐睾症患者,其单侧或双侧隐睾、患者年龄、性腺的原发位置以及治疗方式与18岁时睾丸体积和激素状态之间的关系。
对143名18岁的年轻男性进行评估,他们在童年期接受过单侧(n = 103)或双侧(n = 40)隐睾症治疗。评估项目包括睾丸体积、促黄体生成素(LH)、促卵泡生成素(FSH)和睾酮。
单侧隐睾症:36例患者睾丸位于阴囊前,52例位于腹股沟,15例无法触及。平均体积为9.7 mL,而单侧隐睾症中自然下降的睾丸平均体积为16.2 mL。然而,22例接受人绒毛膜促性腺激素(HCG)治疗的患者睾丸明显更大(11.8 mL),大于接受一期手术治疗的患者(9.2 mL)。结果显示睾丸体积与治疗时患者年龄之间存在显著正相关。双侧隐睾症:34例患者睾丸位于阴囊前,40例位于腹股沟,6例睾丸无法触及。18岁时的平均体积为12.9 mL,大于单侧隐睾的睾丸(9.7 mL),但小于单侧病例中健康对侧睾丸(16.2 mL)。接受HCG治疗后睾丸下降的双侧患者,其睾丸生长与未治疗患者(11.1 mL)或接受一期手术患者(11.4 mL)相比存在显著差异。睾丸体积与可触及睾丸(12.4 mL)或不可触及睾丸(10.4 mL)之间存在显著正相关。单侧或双侧隐睾症与FSH水平之间存在相关性。
童年期诊断并治疗的隐睾症患者,18岁时的睾丸体积和激素功能受未降睾丸是单侧还是双侧的影响很大。诊断时睾丸的位置或初始治疗年龄对18岁时睾丸体积改善或激素水平没有明确影响。