THE ROLE OF ORCHIECTOMY IN TH MANAGEMENT OF POSTPUBERTAL CRYPTORCHIDISM

Abstract

No AccessJournal of UrologyClinical Urology: Original Articles1 Mar 1998THE ROLE OF ORCHIECTOMY IN TH MANAGEMENT OF POSTPUBERTAL CRYPTORCHIDISM EAMONN ROGERS, SEAMUS TEAHAN, HUGH GALLACHER, MICHAEL R. BUTLER, RONALD GRAINGER, T.E.D. MCDERMOTT, and JOHN A. THORNHILL EAMONN ROGERSEAMONN ROGERS , SEAMUS TEAHANSEAMUS TEAHAN , HUGH GALLACHERHUGH GALLACHER , MICHAEL R. BUTLERMICHAEL R. BUTLER , RONALD GRAINGERRONALD GRAINGER , T.E.D. MCDERMOTTT.E.D. MCDERMOTT , and JOHN A. THORNHILLJOHN A. THORNHILL View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63752-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Owing to the risk of future malignancy, many postpubertal male subjects presenting with unilateral cryptorchidism undergo orchiectomy rather than orchiopexy. We examined the incidence of spermatogenesis and carcinogenesis in whole orchiectomy specimens removed from postpubertal cryptorchid male subjects. We review the concept that orchiectomy is justifiable in these patients. Materials and Methods: A total of 52 patients with postpubertal cryptorchidism (unilateral in 48, bilateral in 4) were retrospectively analyzed from 1984. Patient age ranged from 15 to 66 years (mean 26). Six patients presented with primary infertility (unilateral in 3, bilateral in 3). The undescended testicles were palpable in 32 cases (62%). All patients underwent unilateral orchiectomy and whole specimens were examined histologically. Results: Histology showed normal spermatogenesis in only 1 orchiectomy specimen, while 15 had maturation arrest, 6 testicular agenesis and 30 seminiferous tubular atrophy and/or Sertoli-cell-only syndrome with no spermatogenesis. The location of the undescended testis was the superficial inguinal pouch in 32 cases, inguinal canal in 6 and inside the deep ring in 8. Absent spermatogenesis was significantly associated with a high level of maldescent and with increasing age. Two patients (4%) had carcinoma in situ of the testicle. Torsion of an undescended testicle occurred in 1 patient (2%). Conclusions: This analysis of cryptorchid testes in postpubertal male subjects confirms that the majority cannot contribute to fertility, have significant potential and may undergo torsion. Therefore, orchiectomy remains the treatment of choice for the majority of postpubertal male subjects presenting with unilateral cryptorchidism. References 1 : Efficacy of orchiopexy by patient age 1 year for cryptorchidism. J. Urol.1990; 144: 508. Link, Google Scholar 2 : Management of the postpubertal cryptorchid testis: a statistical review. J. Urol.1985; 134: 1071. 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Google Scholar From the Department of Urology, The Meath Hospital, Dublin, Ireland.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byGriffin D, Cambareri G and Kaplan G (2018) Current Practice for Cryptorchidism: Survey of Pediatric UrologistsUrology Practice, VOL. 4, NO. 3, (245-250), Online publication date: 1-May-2017.Koni A, Ozseker H, Arpali E, Kilinc E, Dogan H, Akyol A and Tekgul S (2018) Histopathological Evaluation of Orchiectomy Specimens in 51 Late Postpubertal Men with Unilateral CryptorchidismJournal of Urology, VOL. 192, NO. 4, (1183-1188), Online publication date: 1-Oct-2014.Wood H and Elder J (2018) Cryptorchidism and Testicular Cancer: Separating Fact From FictionJournal of Urology, VOL. 181, NO. 2, (452-461), Online publication date: 1-Feb-2009.RAMAN J and SCHLEGEL P (2018) Testicular Sperm Extraction with Intracytoplasmic Sperm Injection is Successful for the Treatment of Nonobstructive Azoospermia Associated with CryptorchidismJournal of Urology, VOL. 170, NO. 4 Part 1, (1287-1290), Online publication date: 1-Oct-2003.GIWERCMAN A, HANSEN L and SKAKKEBÆK N (2018) INITIATION OF SPERM PRODUCTION AFTER BILATERAL ORCHIOPEXY: CLINICAL AND BIOLOGICAL IMPLICATIONSJournal of Urology, VOL. 163, NO. 4, (1255-1256), Online publication date: 1-Apr-2000. Volume 159Issue 3March 1998Page: 851-854 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information EAMONN ROGERS More articles by this author SEAMUS TEAHAN More articles by this author HUGH GALLACHER More articles by this author MICHAEL R. BUTLER More articles by this author RONALD GRAINGER More articles by this author T.E.D. MCDERMOTT More articles by this author JOHN A. THORNHILL More articles by this author Expand All Advertisement PDF downloadLoading ...