van Brakel J, Dinkelman-Smit M, de Muinck Keizer-Schrama S M P F, Hazebroek F W J, Dohle G R
Urology, Erasmus MC, Rotterdam, Netherlands.
Pediatrics, Endocrinology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.
Andrology. 2017 Jul;5(4):838-843. doi: 10.1111/andr.12384. Epub 2017 Jun 21.
The aim of this study was to compare sperm DNA damage between men with a history of congenital undescended testis (UDT) and men with a history of acquired UDT. A long-term follow-up study of men with previous UDT was performed. Fifty men with congenital UDT who had undergone orchiopexy at childhood age, 49 men with acquired UDT after a 'wait-and-see'-protocol (e.g. awaiting spontaneous descent until puberty and perform an orchiopexy in case of non-decent), and 22 healthy proven fertile men were included. The DNA fragmentation index (DFI) using sperm chromatin structure assay (SCSA) was used to express the level of sperm DNA damage. Decreased fertility potential was considered if DFI was above 30%. Sperm DNA damage was not statistically different between cases of congenital and acquired UDT. DFI was significantly more often >30% in the complete group of men with congenital UDT (9/50; 18%) and in the subgroup with bilateral congenital UDT (3/7; 43%) in comparison with the controls (none) (p-value 0.049 and 0.01, respectively). Age at orchiopexy in congenital UDT had no statistical effect on DNA damage. In men with acquired UDT, DFI did not statistically differ between those having undergone orchiopexy and those experiencing spontaneous descent. This study supports the hypothesis that UDT is a spectrum representing both congenital UDT and acquired UDT. Sperm DNA damage at adult age is not influenced by age at orchiopexy in congenital UDT cases and by orchiopexy or spontaneous descent in acquired UDT cases.
本研究的目的是比较有先天性隐睾（UDT）病史的男性与有后天性UDT病史的男性之间的精子DNA损伤情况。对既往有UDT的男性进行了一项长期随访研究。纳入了50名在儿童期接受过睾丸固定术的先天性UDT男性、49名在采用“观察等待”方案（如等待自发下降直至青春期，若未下降则进行睾丸固定术）后出现后天性UDT的男性，以及22名经证实生育能力正常的健康男性。使用精子染色质结构分析（SCSA）的DNA碎片化指数（DFI）来表示精子DNA损伤水平。如果DFI高于30%，则认为生育潜力降低。先天性和后天性UDT病例之间的精子DNA损伤在统计学上无差异。与对照组（均无DFI>30%）相比，先天性UDT男性全组（9/50；18%）和双侧先天性UDT亚组（3/7；43%）中DFI>30%的情况明显更常见（p值分别为0.049和0.01）。先天性UDT患者睾丸固定术时的年龄对DNA损伤无统计学影响。在后天性UDT男性中，接受睾丸固定术者与自然下降者的DFI在统计学上无差异。本研究支持以下假设：UDT是一种涵盖先天性UDT和后天性UDT的谱系。成年时的精子DNA损伤在先天性UDT病例中不受睾丸固定术时年龄的影响，在后天性UDT病例中不受睾丸固定术或自然下降的影响。
