Cortes D, Thorup J M, Lindenberg S
Department of Pediatric Surgery and Pathology, Righospitalet, University Hospital, Copenhagen, Denmark.
J Urol. 1996 Jul;156(1):217-20. doi: 10.1016/s0022-5347(01)66004-x.
We evaluated whether adult fertility potential was better when unilateral orchiopexy was done at ages 2 to 6 years or later, and we identified those at risk for infertility.
Unilateral orchiopexy was performed simultaneously with testicular biopsy in 11 patients 2.8 to 6.8 years old and in 54, 10.0 to 11.9 years old. In adulthood measurement of testicular volume, serum follicle-stimulating hormone, luteinizing hormone and testosterone was done, as well as analysis of semen specimens.
At orchiopexy the 2 groups were statistically similar, and statistically similar fertility potentials were found in adulthood. Five of the 65 patients (7.7%, 95% confidence limits 2.5 to 17%) may experience infertility, representing 33% of both groups with less than 1% of the age matched number of spermatogonia per tubular transverse section (approximately no germ cells) in the biopsy specimen at orchiopexy.
Between ages 2 and 12 years the timing of unilateral orchiopexy may vary without an effect on subsequent fertility potential. When biopsy at surgery lacks germ cells, there is an approximately 33% age independent risk of subsequent infertility. Otherwise patients may be fertile after unilateral orchiopexy between ages 2 and 12 years.
我们评估了在2至6岁或更晚进行单侧睾丸固定术时，成年后的生育潜力是否更佳，并确定了存在不育风险的人群。
对11例年龄在2.8至6.8岁以及54例年龄在10.0至11.9岁的患者，在进行单侧睾丸固定术的同时进行睾丸活检。成年后测量睾丸体积、血清促卵泡激素、黄体生成素和睾酮，并分析精液标本。
在进行睾丸固定术时，两组在统计学上相似，成年后生育潜力在统计学上也相似。65例患者中有5例（7.7%，95%置信区间2.5至17%）可能会出现不育，这占两组患者的33%，在睾丸固定术时活检标本中每管状横切面的精原细胞数量少于年龄匹配数量的1%（几乎没有生殖细胞）。
在2至12岁之间，单侧睾丸固定术的时机可以不同，而不会影响随后的生育潜力。当手术时活检缺乏生殖细胞时，随后不育的年龄独立风险约为33%。否则，2至12岁之间进行单侧睾丸固定术的患者可能具有生育能力。
