Department of Urology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
Department of Urology, Sanyo-Onoda Municipal Hospital, Sanyo-Onoda, Yamaguchi, Japan.
J Urol. 2021 Oct;206(4):1031-1037. doi: 10.1097/JU.0000000000001896. Epub 2021 May 25.
Testicular temperature should remain low to maintain optimal function of germ cells; however, information regarding testicular temperature in infants and the effect of cryptorchidism and its correction, including laparoscopic staged Fowler-Stephens orchiopexy (LSFSO), is limited.
A total of 82 infants with unilateral palpable cryptorchidism, 24 with nonpalpable testes who underwent unilateral LSFSO and 20 with scrotal hydrocele were included. Ultrasonographic determination of testicular volume and measurement of testicular temperature but not scrotal surface temperature using a Coretemp CTM204 (Terumo, Tokyo) were performed before and 12 months after orchiopexy. The effects of the route of testicular delivery, conventionally through a new hiatus medial to the inferior epigastric vessels or through the transinguinal approach, were investigated in the LSFSO cases.
Undescended testicular volume was significantly increased after orchiopexy (0.80 ml to 0.92 ml, p <0.0001). The preoperative testicular temperature (35.1C) was significantly higher than that of the control (34.4C, p <0.0001), and significant decreases in testicular temperature occurred after orchiopexy (34.3C, p <0.0001). A multivariate analysis showed that a decrease in testicular temperature was a factor associated with postoperative testicular development. Twelve months after LSFSO, transinguinal approach was shown to be more effective in decreasing the testicular temperature than the conventional approach (34.4 and 35.3C, respectively, p <0.05).
Orchiopexy is effective in correcting the high-temperature environment caused by cryptorchidism. In the case of nonpalpable testes treated by LSFSO, transinguinal fixation is more effective than the conventional approach in reducing testicular temperature, but a longer followup period is necessary to draw a final conclusion.
睾丸温度应保持较低以维持精原细胞的最佳功能；然而，有关婴儿睾丸温度以及隐睾症及其矫正（包括腹腔镜分期 Fowler-Stephens 睾丸固定术（LSFSO））的信息有限。
共纳入 82 例单侧可触及隐睾症婴儿、24 例不可触及睾丸行单侧 LSFSO 及 20 例鞘膜积液婴儿。在睾丸固定术前和术后 12 个月，使用 Coretemp CTM204（Terumo，东京）行超声测量睾丸体积和睾丸温度（而非阴囊表面温度）。在 LSFSO 病例中，研究了睾丸输送途径（常规通过下腹部血管内侧的新裂孔或经腹股沟途径）的影响。
睾丸固定术后未降睾丸体积明显增加（0.80ml 至 0.92ml，p<0.0001）。术前睾丸温度（35.1°C）明显高于对照组（34.4°C，p<0.0001），睾丸固定术后睾丸温度显著下降（34.3°C，p<0.0001）。多变量分析显示，睾丸温度下降是与术后睾丸发育相关的因素。LSFSO 术后 12 个月，经腹股沟途径较常规途径更有效地降低睾丸温度（分别为 34.4°C 和 35.3°C，p<0.05）。
睾丸固定术有效纠正隐睾症引起的高温环境。对于 LSFSO 治疗的不可触及睾丸，经腹股沟固定较常规途径更有效地降低睾丸温度，但需要更长的随访时间得出最终结论。
