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Age at orchiopexy and testis palpability predict germ and Leydig cell loss: clinical predictors of adverse histological features of cryptorchidism.
J Urol. 2009 Aug; 182(2):704-9.JU

Abstract

PURPOSE

We determined the relationship between clinical variables and testicular histopathological changes associated with decreased fertility potential in children with cryptorchidism.

MATERIALS AND METHODS

Testis biopsies of 274 children who underwent orchiopexy and concurrent testicular biopsy between 1991 and 2001 were analyzed for germ and Leydig cell loss, and testicular fibrosis. Multivariable logistic regression was used to determine if age at orchiopexy (analyzed as continuous and ordinal variables), preoperative testis palpability, unilateral vs bilateral disease and/or side of undescended testis was predictive of these pathological outcomes.

RESULTS

Age at orchiopexy was associated with germ and Leydig cell depletion. Each month of testis undescent was associated with development of moderate/severe germ cell depletion (OR 1.02 for each month of age, p <0.005) and Leydig cell loss (OR 1.01 for each month of age, p <0.02). Nonpalpable testes were associated with severe germ cell depletion. Children with palpable testes had lower odds of germ cell depletion than those with nonpalpable testes (OR 0.46, p <0.005). This finding corresponds to a significant 2% risk per month of severe germ cell loss and 1% risk per month of Leydig cell depletion for each month a testis remains undescended, and a 50% greater risk of germ cell depletion in nonpalpable relative to palpable cryptorchid testes.

CONCLUSIONS

Testes that remain undescended are associated with progressive loss of germ and Leydig cells, and nonpalpable testes predict severe germ cell loss.

Authors+Show Affiliations

Department of Urology, University of California-San Francisco, San Francisco, California 94143-0738, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19539332

Citation

Tasian, Gregory E., et al. "Age at Orchiopexy and Testis Palpability Predict Germ and Leydig Cell Loss: Clinical Predictors of Adverse Histological Features of Cryptorchidism." The Journal of Urology, vol. 182, no. 2, 2009, pp. 704-9.
Tasian GE, Hittelman AB, Kim GE, et al. Age at orchiopexy and testis palpability predict germ and Leydig cell loss: clinical predictors of adverse histological features of cryptorchidism. J Urol. 2009;182(2):704-9.
Tasian, G. E., Hittelman, A. B., Kim, G. E., DiSandro, M. J., & Baskin, L. S. (2009). Age at orchiopexy and testis palpability predict germ and Leydig cell loss: clinical predictors of adverse histological features of cryptorchidism. The Journal of Urology, 182(2), 704-9. https://doi.org/10.1016/j.juro.2009.04.032
Tasian GE, et al. Age at Orchiopexy and Testis Palpability Predict Germ and Leydig Cell Loss: Clinical Predictors of Adverse Histological Features of Cryptorchidism. J Urol. 2009;182(2):704-9. PubMed PMID: 19539332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age at orchiopexy and testis palpability predict germ and Leydig cell loss: clinical predictors of adverse histological features of cryptorchidism. AU - Tasian,Gregory E, AU - Hittelman,Adam B, AU - Kim,Grace E, AU - DiSandro,Michael J, AU - Baskin,Laurence S, Y1 - 2009/06/17/ PY - 2008/12/06/received PY - 2009/6/23/entrez PY - 2009/6/23/pubmed PY - 2009/8/7/medline SP - 704 EP - 9 JF - The Journal of urology JO - J. Urol. VL - 182 IS - 2 N2 - PURPOSE: We determined the relationship between clinical variables and testicular histopathological changes associated with decreased fertility potential in children with cryptorchidism. MATERIALS AND METHODS: Testis biopsies of 274 children who underwent orchiopexy and concurrent testicular biopsy between 1991 and 2001 were analyzed for germ and Leydig cell loss, and testicular fibrosis. Multivariable logistic regression was used to determine if age at orchiopexy (analyzed as continuous and ordinal variables), preoperative testis palpability, unilateral vs bilateral disease and/or side of undescended testis was predictive of these pathological outcomes. RESULTS: Age at orchiopexy was associated with germ and Leydig cell depletion. Each month of testis undescent was associated with development of moderate/severe germ cell depletion (OR 1.02 for each month of age, p <0.005) and Leydig cell loss (OR 1.01 for each month of age, p <0.02). Nonpalpable testes were associated with severe germ cell depletion. Children with palpable testes had lower odds of germ cell depletion than those with nonpalpable testes (OR 0.46, p <0.005). This finding corresponds to a significant 2% risk per month of severe germ cell loss and 1% risk per month of Leydig cell depletion for each month a testis remains undescended, and a 50% greater risk of germ cell depletion in nonpalpable relative to palpable cryptorchid testes. CONCLUSIONS: Testes that remain undescended are associated with progressive loss of germ and Leydig cells, and nonpalpable testes predict severe germ cell loss. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/19539332/Age_at_orchiopexy_and_testis_palpability_predict_germ_and_Leydig_cell_loss:_clinical_predictors_of_adverse_histological_features_of_cryptorchidism_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2009.04.032?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -