Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, North-15, West-7, Kita-Ku, Sapporo, 060-8638, Japan.
World J Urol. 2019 Dec;37(12):2795-2799. doi: 10.1007/s00345-019-02687-w. Epub 2019 Feb 28.
The factors affecting spermatogenesis in adulthood in patients with hypospadias (HS) are not clearly understood. In the present study, risk factors affecting post-pubertal high serum follicle-stimulating hormone (FSH) were evaluated in patients with HS.
Among those with a history of HS surgery, patients in whom endocrinological evaluation regarding pituitary-gonadal axis was performed at 15 years of age or older between March 2004 and April 2018 were enrolled in the present study. High serum FSH was defined as greater than 10 mIU/ml. The severity of HS was divided into mild and severe. Factors affecting the post-pubertal high serum FSH were estimated.
Seventy-nine patients were included in the present study. The severity of HS was mild in 35 and severe in 44. History of undescended testis (UDT) was confirmed in 12. High serum FSH was detected in nine. On logistic regression model analysis, a history of UDT was the only significant factor for high serum FSH. The incidence of high serum FSH in patients with UDT was significantly higher than that in those without UDT (58.3% vs 7.5%, p < 0.01). When stratified by severity of HS and the presence of UDT, high serum FSH was detected in 70% in patients with severe HS and UDT, whereas less than 10% in other groups.
A history of UDT was a significant factor for post-pubertal high serum FSH in patients with HS. Accordingly, the presence of UDT may be a marker for impaired spermatogenesis in patients with HS, especially in severe cases.
导致尿道下裂（HS）患者成年后精子发生障碍的因素尚不清楚。本研究评估了影响 HS 患者青春期后高血清卵泡刺激素（FSH）的危险因素。
本研究纳入了 2004 年 3 月至 2018 年 4 月间接受过 HS 手术且在 15 岁或以上时进行过垂体-性腺轴内分泌评估的患者。高血清 FSH 定义为大于 10 mIU/ml。HS 的严重程度分为轻度和重度。评估了影响青春期后高血清 FSH 的因素。
本研究共纳入 79 例患者。HS 严重程度轻度 35 例，重度 44 例。12 例患者有隐睾史（UDT）。9 例患者血清 FSH 升高。Logistic 回归模型分析显示，UDT 病史是导致高血清 FSH 的唯一显著因素。UDT 患者高血清 FSH 的发生率明显高于无 UDT 患者（58.3%比 7.5%，p < 0.01）。按 HS 严重程度和 UDT 存在情况分层，重度 HS 和 UDT 患者的高血清 FSH 发生率为 70%，而其他组不到 10%。
UDT 病史是 HS 患者青春期后高血清 FSH 的显著因素。因此，UDT 的存在可能是 HS 患者精子发生受损的标志物，尤其是在重度 HS 患者中。
