Coughlin M T, Bellinger M F, LaPorte R E, Lee P A
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA, USA.
J Pediatr Surg. 1998 Dec;33(12):1790-3. doi: 10.1016/s0022-3468(98)90286-x.
BACKGROUND/PURPOSE: Although fertility is decreased after cryptorchidism, the importance of risk factors, including parenchymal testicular suture, is unknown. The aim of this study was to examine the relationship between parenchymal testicular suture and failure to conceive a child for 1 year or longer among formerly cryptorchid men.
Men who underwent orchidopexy between 1955 and 1972 at the Children's Hospital of Pittsburgh (n = 619) were surveyed by questionnaire and their medical records reviewed. Only the men who attempted to conceive a child (n = 387) are included.
Logistic regression analysis determined significant risk factors for infertility. Testicular suture was strongly related to infertility (RR, 7.56; 95% CI, 1.66, 34.39) as were bilateral cryptorchidism (RR, 5.51; 95% CI, 1.58, 19.24), varicocele (RR, 4.72; 95% CI, 1.42, 15.75), hormone treatment before surgery (RR, 3.69; 95% CI, 1.22, 11.11), and partner conception problem (RR, 3.32; 95% CI, 1.11, 9.90).
Testicular suture was a potent independent determinant of infertility among formerly cryptorchid men who have orchidopexy. Bilateral cryptorchidism, hormone treatment, varicocele, and partner conception problems also were associated with increased infertility.
背景/目的：尽管隐睾症后生育能力会下降，但包括睾丸实质缝合在内的风险因素的重要性尚不清楚。本研究的目的是探讨睾丸实质缝合与既往患有隐睾症的男性1年及以上未能受孕之间的关系。
通过问卷调查对1955年至1972年在匹兹堡儿童医院接受睾丸固定术的男性（n = 619）进行调查，并查阅他们的病历。仅纳入尝试受孕的男性（n = 387）。
逻辑回归分析确定了不孕的显著风险因素。睾丸缝合与不孕密切相关（相对危险度，7.56；95%可信区间，1.66，34.39），双侧隐睾症（相对危险度，5.51；95%可信区间，1.58，19.24）、精索静脉曲张（相对危险度，4.72；95%可信区间，1.42，15.75）、术前激素治疗（相对危险度，3.69；95%可信区间，1.22，11.11）以及配偶受孕问题（相对危险度，3.32；95%可信区间，1.11，9.90）也是如此。
睾丸缝合是既往接受睾丸固定术的隐睾症男性不孕的一个有力独立决定因素。双侧隐睾症、激素治疗、精索静脉曲张和配偶受孕问题也与不孕增加有关。
