Lenzi A, Gandini L, Lombardo F, Dondero F, Culasso F, Ferro F, Cambiaso P, Caione P, Cappa M
University of Rome La Sapienza, Italy.
Fertil Steril. 1997 May;67(5):943-8. doi: 10.1016/s0015-0282(97)81412-4.
To evaluate whether prepubertal orchidopexy for unilateral cryptorchidism can reduce adult dysspermia.
Patient follow-up comparison with control groups.
Surgical and endocrinologic sections of a children's hospital and a university infertility-care center.
PATIENT(S): Seventy-one patients with unilateral cryptorchidism who underwent orchidopexy in prepubertal age (6.4 +/- 2.8 years) were followed up as adults (20.0 +/- 2.8 years).
MAIN OUTCOME MEASURE(S): Patients underwent testicular examination and hormonal evaluation, 49 of these had semen analysis and antisperm antibody tests. Semen results were compared with those of two age-matched control groups: a group of 20 healthy, randomly selected subjects and a group of 20 patients operated on in postpubertal age for cryptorchidism.
RESULT(S): Unilateral reduced testis size was found in 30.1% of patients, eight patients had a low LH level, eight had a low T level, and none had abnormal FSH values. Antisperm antibodies were found in 1 of 49 cases. Cluster analysis of sperm parameters showed that the mean values of patients were worse than those of the healthy controls but better than those of the subjects operated on in postpubertal age.
CONCLUSION(S): This study indicates that prepubertal orchidopexy can given better results than postpubertal correction.
评估青春期前单侧隐睾固定术能否降低成年后的精子发生障碍。
与对照组进行患者随访比较。
一家儿童医院的外科和内分泌科以及一所大学的不孕不育治疗中心。
71例青春期前(6.4±2.8岁)接受隐睾固定术的单侧隐睾患者成年后(20.0±2.8岁)接受随访。
患者接受睾丸检查和激素评估,其中49例进行了精液分析和抗精子抗体检测。将精液检测结果与两个年龄匹配的对照组进行比较:一组为随机选取的20名健康受试者,另一组为青春期后接受隐睾手术的20例患者。
30.1%的患者单侧睾丸体积减小,8例患者促黄体生成素(LH)水平低,8例睾酮(T)水平低,无一例卵泡刺激素(FSH)值异常。49例中有1例检测到抗精子抗体。精子参数的聚类分析显示,患者的平均值比健康对照组差,但比青春期后手术的受试者好。
本研究表明,青春期前隐睾固定术比青春期后矫正术效果更好。