Lugg J A, Penson D F, Sadeghi F, Petrie B, Freedman A L, Gonzalez-Cadavid N F, Hikim A S, Rajfer J
Department of Surgery, UCLA School of Medicine, Harbor-UCLA Medical Center, Torrance 90509, USA.
J Androl. 1996 Nov-Dec;17(6):726-32.
In an attempt to determine whether the seminiferous tubular atrophy of the cryptorchid testis is preventable by early surgical correction of the cryptorchid state, aberrantly developed gubernacula destined to result in a cryptorchid testis in the Long-Evans cryptorchid (LE/ORL) rat were surgically reimplanted to the bottom of the scrotum on day 10 to 12 of age. Testis descent was monitored and the changes in testicular histology and in the volumes of the seminiferous tubules and Leydig cells were examined at day 60. As expected, normal testis descent occurred on or about day 25. Compared to untreated undescended testes at day 60, relative seminiferous tubular volumes (volume: % +/- SEM) were significantly increased by early surgical reimplantation of the gubemacula (89 +/- 1 vs. 66 +/- 3; P < 0.01). Absolute seminiferous tubular volumes (microliter +/- SEM) were also significantly increased by early surgical intervention when compared to undescended nontreated testes (893 +/- 27 vs. 170 +/- 12; P < 0.01). The testes of the surgically corrected cryptorchid animals were similar in all respects to those found in the descended testes of the sham-operated controls. Relative Leydig cell volume (% +/- SEM) was increased in the untreated cryptorchid testes compared to the surgically corrected testes (5.2 +/- 0.6 vs. 1.2 +/- 1.0; P < 0.05). Relative Leydig cell volumes in the surgically corrected testes were not significantly different from those found in the sham-operated descended controls. A modest but significant (P < 0.05) increase in absolute Leydig cell volume was also noted in the cryptorchid testes when compared both to normal controls or surgically corrected cryptorchid testes. From these observations, we conclude that early gubernaculopexy reverses the histologic changes normally seen in the cryptorchid rat testis to a relatively normal histologic architecture. These data provide experimental evidence to support the value of orchiopexy in the treatment of cryptorchidism.
为了确定隐睾的生精小管萎缩是否可通过早期手术矫正隐睾状态来预防,在长-伊文斯隐睾(LE/ORL)大鼠出生后第10至12天,将注定导致隐睾的发育异常的睾丸引带手术重新植入阴囊底部。监测睾丸下降情况,并在第60天检查睾丸组织学变化以及生精小管和莱迪希细胞体积的变化。正如预期的那样,正常的睾丸下降发生在第25天左右。与第60天未治疗的隐睾相比,早期手术重新植入睾丸引带可使相对生精小管体积(体积:%±标准误)显著增加(89±1对66±3;P<0.01)。与未治疗的隐睾相比,早期手术干预也使绝对生精小管体积(微升±标准误)显著增加(893±27对170±12;P<0.01)。手术矫正隐睾动物的睾丸在各方面与假手术对照组下降睾丸相似。与手术矫正的睾丸相比,未治疗的隐睾中相对莱迪希细胞体积(%±标准误)增加(5.2±0.6对1.2±1.0;P<0.05)。手术矫正睾丸中的相对莱迪希细胞体积与假手术下降对照组中的无显著差异。与正常对照组或手术矫正的隐睾睾丸相比,隐睾睾丸中的绝对莱迪希细胞体积也有适度但显著(P<0.05)的增加。从这些观察结果中,我们得出结论,早期睾丸引带固定术可将隐睾大鼠睾丸中通常所见的组织学变化逆转至相对正常的组织结构。这些数据为支持睾丸固定术在治疗隐睾症中的价值提供了实验证据。