Antisperm Antibodies in Cryptorchidism Before and After Surgery (original) (raw)
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Cryptorchidism and its Effects on Histomorphology of Testis in Paediatric Age Group
Journal of Evolution of Medical and Dental Sciences, 2019
BACKGROUND Numerous histological studies on undescended testis have attempted to understand the pathophysiology of cryptorchidism and have helped in the clinical management of this congenital aberration. Undescended testis is associated with high risk of infertility and cancer. This study was performed on orchidectomy specimens of cryptorchidism at a tertiary paediatric referral centre in order to understand the histological changes of cryptorchidism and correlate them with age. METHODS A retrospective study of 5 years was performed at a tertiary paediatric referral centre. 21 orchidectomy specimens of undescended testis were included in the study. Most of the cases were associated with torsion as orchidectomy was not performed for viable testis and a direct orchiopexy was done. Specimens with large areas of haemorrhage and necrosis were excluded and microscopically viable areas were studied. Seven histological criteria were taken into account and correlated with histology. An extensive review of literature was done. RESULTS Histology revealed that all the seven microscopic criteria taken into account including absence of germ cells were more severe with increasing age of the patients. CONCLUSIONS To avoid irreversible damage to germinal cells, orchiopexy should be performed early, and a simultaneous biopsy should be taken to know the degree of histological changes and to determine the necessity of institution of supplementary hormonal treatment. At the time of birth, cryptorchid testis do harbour germ cells. But from fifteen years of age onwards, germ cells decrease. In our study, most normal findings were observed in children of less than two years of age; afterwards there was a damage of tubules and epithelium and fibrosis of the stroma was seen. As proven by many studies earlier, orchiopexy is needed for cryptorchidism. Also, a testicular biopsy should be performed in older boys in order to give any hormonal supplementation if needed.
HORMONAL TREATMENT MAY HARM THE GERM CELLS IN 1 TO 3YEAROLD BOYS WITH CRYPTORCHIDISM
Journal of Urology, 2000
Purpose: Hormonal treatment with human chorionic gonadotropin (HCG) or gonadotropin releasing hormone may be given initially for cryptorchidism. We evaluated whether hormonal treatment is safe for the germ cells in boys with cryptorchidism 1 to 3 years old in whom follicle-stimulating hormone, luteinizing hormone and testosterone values are normally low.
International braz j urol, 2015
To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood. Materials and Methods: Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism. Results: Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 mL. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment. Bilateral cryptorchidism: Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH. Conclusions: Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or age of initial treatment exerts no definite effect on testicular volume improvement or hormonal levels at 18 years of age.
“CRYPTORCHIDISM” EMBRYOLOGICAL BASIS AND ITS CLINICAL IMPORTANCE
Cryptorchidism is the most common defect of the male urogenital tract at birth. It signifies a risk factor for primitive testiculopathy associated with long-term complications (infertility, testicular neoplasia, and hormonal changes). It may appear as an isolated disorder or can be a consequence of genetic and endocrine abnormalities connected with somatic anomalies. Its genetic relation still seems to be indistinct although a choice of genes can be answerable for the growth of this syndrome. Cryptorchidism can be related with serum testosterone level though the co-existing hypogonadotropic hypogonadism may also designate the association of pituitary hormones.
The Importance of Mini-Puberty for Fertility in Cryptorchidism
The Journal of Urology, 2005
Purpose: Mini-puberty is the hormonal surge of gonadotropins and testosterone which occurs in early infancy. It induces the development and transformation of gonocytes into Ad spermatogonia, which is impaired in many cryptorchid testes. We examine the role of testosterone in the transformation and development of Ad spermatogonia.
Acquired cryptorchidism in a boy with disorder of sex development
Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology, 2012
Recently, it has been reported that boys with severe hypospadias are at increased risk for acquired cryptorchidism. The reports suggested that prenatal and postnatal androgen disruption might be correlated with this condition. We experienced a case of ovotesticular disorder of sex development (DSD), which was ultimately diagnosed at surgery for acquired cryptorchidism. Ascent of the scrotal contents of the left side was detected in a 7-yr-old boy with the 46, XX karyotype, who had a history of perineal hypospadias repair. Intraoperative findings revealed the left gonad consisted of 2 segments, and this was histologically diagnosed as ovotestis by biopsy specimen. Resection of the ovarian segment was performed simultaneously. Exploration of the contralateral gonad showed the same findings. This is the first report of acquired cryptorchidism observed in a patient with DSD presenting with ambiguous genitalia.
Cryptorchidism: its influence on male fertility and the risk of the testicular tumor
International Surgery Journal
In the embryonic stage, the testes develop in the abdomen and descend to scrotum, just before or at birth. The undescended testis is the result of the arrest of descent of testis in some part along its path, to the scrotum. The bilateral undescended testis is called Cryptorchidism which means hidden testis. The factors that contribute to the descent of testis includes Gubernaculum testis, the differential growth of abdominal wall, intra-abdominal pressure and temperature, Calcitonin gene-related peptide (CGRP), male sex hormones, insulin-like hormone 3 (INSL3) and maternal gonadotrophins. The descent of testis may become erratic and gives rise to undescended testis, ectopic testis, congenital hernia, and hydrocoele etc. As a rough estimate approximately 2-4% of male infants are born with Cryptorchism, thus making it, one of the most common congenital anomalies, in the male genitalia. It was found that the incidence of azoospermia in unilateral cryptorchidism was 13%, but in untreate...
Endocrine, 2012
The aim of this study was to measure the serum AMH (anti-Mullerian hormone) concentrations in a group of boys with or without cryptorchidism, evaluation of karyotypes, testicular position, morphology, and major length of the undescended testes. Fifty boys who were 1–4 years old (median = 2.4 years) with unilateral cryptorchidism were evaluated. All of them underwent orchidopexy in 2010. Prior to the procedure, all of the subjects had undergone karyotyping to exclude chromosomal abnormalities. Fifty healthy boys within the same age range (median = 2.1 years) admitted for planned inguinal hernia repair in 2010, served as controls. Blood samples were collected, while obtaining blood for standard laboratory tests routinely performed before the surgeries. Medians of AMH in boys with cryptorchidism were lower than in boys with inguinal hernia and differed significantly between two groups. Undescended testes were generally found in superficial inguinal pouch (n = 46), in two cases were noted to be in the external ring of the inguinal canal, and in another two instances, in the abdominal cavity. The major lengths of the undescended testes were smaller in comparison to the testes positioned normally (mean of 1 cm vs. a mean of 1.5 cm, respectively). In nine of the cases, the testes had turgor deficit, a drop shape, with epididymides that were small, dysplastic, and separated from the testis. The authors found that AMH was lower in boys with unilateral cryptorchidism (also found to have smaller testis) when compared with the control group.