Verkauskas Gilvydas, Malcius Dalius, Dasevicius Darius, Hadziselimovic Faruk
1 Children's Surgery Centre, Vilnius University Faculty of Medicine, Vilnius, Lithuania.
2 Department of Pediatric Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Pediatr Dev Pathol. 2019 Jan-Feb;22(1):53-58. doi: 10.1177/1093526618789300. Epub 2018 Jul 16.
Defective mini-puberty inducing insufficient gonadotropin secretion is one of the most common causes of nonobstructive azoospermia in men suffering from congenital isolated unilateral or bilateral cryptorchidism. The aim of our study was to determine the risk for azoospermia by histologic criteria in a cohort of unilateral cryptorchid boys undergoing orchidopexy and bilateral testicular biopsy. We performed a retrospective analysis of data available in the library of the Cryptorchidism Research Institute, Liestal, Switzerland. Complete histological evaluations were available for 319 boys operated on for unilateral cryptorchidism with simultaneous biopsy of the contralateral descended testicle. The median age was 39 (5-192) months and 58 patients were <18 months of age. Forty-eight percent of undescended testis (UDT) and 21% of contralateral testis had no A dark (Ad) spermatogonia. Furthermore, in 11% of boys Ad spermatogonia were lacking in both testes. Positive correlation was found between the spermatogonia/tubule ratio of the UDT and contralateral testis (Spearman rank order correlation is 0.16, P = .003). The extent of alteration in the UDT correlated with the contralateral descended testis, indicating that unilateral cryptorchidism is a bilateral disease. Observed impaired transition from gonocytes into Ad spermatogonia indicates defective mini-puberty, providing one of explanations for azoospermia and infertility development in unilateral cryptorchid men.
导致促性腺激素分泌不足的迷你青春期缺陷是先天性孤立性单侧或双侧隐睾症男性非梗阻性无精子症最常见的原因之一。我们研究的目的是通过组织学标准确定一组接受睾丸固定术和双侧睾丸活检的单侧隐睾男孩患无精子症的风险。我们对瑞士利斯塔尔隐睾症研究所图书馆中的可用数据进行了回顾性分析。对319名单侧隐睾症手术且同时对侧下降睾丸活检的男孩进行了完整的组织学评估。中位年龄为39（5 - 192）个月，58名患者年龄小于18个月。48%的未降睾丸（UDT）和21%的对侧睾丸没有A暗型（Ad）精原细胞。此外，11%的男孩双侧睾丸均缺乏Ad精原细胞。UDT和对侧睾丸的精原细胞/小管比率之间存在正相关（Spearman等级相关为0.16，P = 0.003）。UDT的改变程度与对侧下降睾丸相关，表明单侧隐睾症是一种双侧性疾病。观察到的从生殖母细胞向Ad精原细胞的转变受损表明迷你青春期存在缺陷，这为单侧隐睾症男性无精子症和不育症的发生提供了一种解释。
