Unidade de Pesquisa Urogenital, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brasil.
Int Braz J Urol. 2022 Mar-Apr;48(2):336-346. doi: 10.1590/S1677-5538.IBJU.2022.99.07.
To analyze the incidence of epididymal anomalies (EAs) associated to spermatic obstruction in patients with undescended testis (UT) according to testicular position and age.
We studied 87 patients (110 testis) with cryptorchidism and analyzed the presence of EAs correlated with the testicular position, age and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis we considered three situations: (a) Normal pattern: the epididymis was attached to the testis at the head and tail and epididymis totally attached to the testis; (b) EAs: when the epididymis was attached to the testis only at the head (Figure-1A) and (c) EAs associated to spermatic obstruction: epididymis was attached to the testis only at the tail (Figure-1B) and when there are no visible connection between testis and epididymis (Figure-1C). We used the Wilcoxon-Mann-Whitney test and the Chi-square test for contingency analysis (p <0.05).
The mean age of the patients was 5.18 years (SD=2.867). Of 110 testes analyzed, 14 were abdominal (12.72%); 83 inguinal (75.45%) and 13 suprascrotal (11.81%). Normal relationships between testis and epididymis were observed in 54 patients (62.1%) with no significant differences in relation to the patient's age (p=0.666). Epididymal tail disjunction was observed in 23 patients (26.44%), with no significant differences in relation to age (p=0.59). EAs associated to spermatic obstruction were observed in 16 patients (18.4%), also with no significant differences in relation to age (p=0.684). We did not observe significant correlation between the testis position and the incidence of EAs (p=0.119). We did not observe significant correlations between patency of the PV (64.7%) and incidence of EAs (p=0.742).
Epididymal anomalies associated with spermatic obstruction are present in almost 20% of undescended testes, without significant correlation with age, testicular position and patency of the PV. This information needs to be correlated to the infertility risk of this congenital anomaly.
分析隐睾患者中附睾异常（EA）与精索阻塞的相关性，根据睾丸位置和年龄进行分析。
我们研究了 87 例隐睾患者（110 个睾丸），分析了与睾丸位置、年龄和鞘状突通畅性相关的 EA 存在情况。为了分析睾丸和附睾之间的关系，我们考虑了三种情况：（a）正常模式：附睾头部和尾部附着于睾丸，附睾完全附着于睾丸；（b）EA：当附睾仅附着于睾丸头部时（图 1A）；（c）EA 伴精索阻塞：附睾仅附着于睾丸尾部（图 1B），并且睾丸和附睾之间没有可见的连接（图 1C）。我们使用 Wilcoxon-Mann-Whitney 检验和卡方检验进行连续性分析（p<0.05）。
患者的平均年龄为 5.18 岁（SD=2.867）。110 个睾丸中，14 个位于腹部（12.72%）；83 个位于腹股沟（75.45%），13 个位于阴囊上方（11.81%）。在 54 例（62.1%）患者中观察到睾丸和附睾之间的正常关系，与患者年龄无显著差异（p=0.666）。在 23 例（26.44%）患者中观察到附睾尾部分离，与年龄无显著差异（p=0.59）。在 16 例（18.4%）患者中观察到与精索阻塞相关的 EA，与年龄也无显著差异（p=0.684）。我们没有观察到睾丸位置与 EA 发生率之间存在显著相关性（p=0.119）。我们也没有观察到鞘状突通畅性（64.7%）与 EA 发生率之间存在显著相关性（p=0.742）。
隐睾患者中与精索阻塞相关的附睾异常发生率约为 20%，与年龄、睾丸位置和鞘状突通畅性无显著相关性。这些信息需要与这种先天性异常的不育风险相关联。
