Histological Changes of the Cryptorchid Testis According to the Age / 대한비뇨기과학회지

ABSTRACT

PURPOSE: To obtain fundamental data for the ideal timing of an orchiopexy, we evaluated the histological findings of the cryptorchid testis based on the childrens age. MATERIALS AND METHODS: A total of 53 patients underwent orchiopexy and testis biopsy. Thirty eight patients with unilateral inguinal cryptorchid testis were divided into 4 groups based on their age; 4 yrs (n=7). The other groups included patients having intraabdominal testis (n=5), bilateral inguinal cryptorchid testis (n=7) and other accompanied diseases with cryptorchid testis (n=3). We measured all the testicular size and analyzed the following histological parameters; mean tubular diameter (MTD), mean tubular fertilization index (MTFI), germ cell count (GCC), Sertoli cell index (SCI) and interstitial cell fibrosis (ICF). RESULTS: In patients younger than 1 year, all the histological parameters such as MTD, MTFI, GCC, SCI and ICF were better than those of patients older. In all patients less than 2 years of age, the testicular size was smaller (p=0.068) but the histological parameters such as MTFI (p=0.011) and GCC (p=0.012) were significantly superior to those of patients older than 2 years. Most of the bilateral inguinal (n=6/7) and intraabdominal cryptorchid testis (n=3) exhibited a significantly lower MTFI and GCC than the age-matched unilateral inguinal cryptorchid testis. CONCLUSIONS: Orchiopexy should be performed within the first 2 years of age in order to prevent significant histological degeneration. Moreover, early orchiopexy is preferred during the first year of life. In particular, based on our limited data, earlier orchiopexy should be considered in patients with bilateral inguinal or intraabdominal cryptorchid testes.