study on cryptorchidism a comparison of histological finding in the germinative epithelium before and after the age of 2 years

ABSTRACT

Undescended testis is a common problem with high risk of infertility and cancer. Early surgical correction is important for prevention of those risks. In the last year 1999, multi-disciplinary projects were done between surgical, dermatological and pediatric departments aiming to re-explore the histological and morphological changes in cryptorchid testis and its relation to age. Twenty four [24] male patients were recruited from El-Minia University Hospital and were divided into 4 main groups. Group A included 6 infants under the age of 2 years; group B included 4 patients aged from 2-9 years [pre-pubertal]; group C included 6 patients aged from 9 to 14 years [pubertal]; and group D included 8 patients aged from 14 to 21 years [post-pubertal]. Orchiopexy was done for all patients in one stage and bilateral testicular biopsy was taken and fixed immediately in Baun's solution and then stained by H and E for histopathological preparations. Our results showed that, for boys under the age of 2 years, there was no change from the normal spermatogonia and Sertoli cells with no thickening of their basement membrane. In pre-pubertal children, we found that changes were evident by the age of 7 and 8 years in the form of decreased number of spermatogonia, delayed maturation of Sertoli cells, widening of interstitial spaces and increased number of fibroblasts in the interstitium. In pubertal patients, the spermatogonia became rare and Sertoli cells were immature. Biopsy specimens from post-pubertal patients showed marked reduction of spermatogonia and arrest of spermatogenesis at primary spermatocyte stage. We concluded that early correction of cryptorchidism is vital for preservation of testicular integrity and maintenance of fertility