Skip to main content
SpringerLink
Log in

Evaluating testicular function changes in unilateral cryptorchid chinese infants underwent orchidopexy in the first year of life

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Objective

Management of cryptorchidism is typically recommended within the first 18 months of life to maximize fertility potential. However, there is a paucity of longitudinal postoperative data for Chinese infants. We aim to evaluate the Testicular function change when the procedure is done within the first year of life.

Method

We prospectively enrolled 51 children diagnosed with unilateral inguinal cryptorchidism into the surgical group between January 2021 and January 2022. Orchidopexy was carried out through a single transverse scrotal incision. Assessments of anti-Mullerian hormone (AMH), inhibin B (InhB), testosterone (T) levels, testicular volume and testicular atrophy index (TAI) were conducted at baseline, 6 months, and 1 year following surgery. Concurrently, clinical data from 42 healthy age-matched controls were collected during their routine physical examinations.

Results

At 6- and 12-months post-surgery, testicular volume increased significantly to 0.98 ± 0.12 mL and 1.01 ± 0.12ml. AMH levels also rose from 76.40 ± 15.77 ng/mL to 81.52 ± 15.32 ng/mL and 87.50 ± 15.36 ng/mL. However, these parameters are significantly lower than age-matched healthy controls (both P < 0.001). InhB levels significantly increased after surgery and even surpassed those of healthy controls after 6 months (both P < 0.001). The TAI was 16.7% and 8.6% at 6- and 12-months following surgery.

Conclusion

Although orchiopexy can improve testicular growth and function, the restoration of testicular function to the level of healthy peers might take longer. To expedite the recovery of testicular function and bring it in line with that of peers, we recommend addressing cryptorchidism at the earliest opportunity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

References

  1. Ceccanti S, Migliara G, De Vito C, Cozzi DA (2022) Prevalence, management, and outcome of cryptorchidism associated with gastroschisis: a systematic review and meta-analysis. J Pediatr Surg 57(7):1414–1422

    Article  PubMed  Google Scholar 

  2. Fawzy F, Hussein A, Eid MM, El Kashash AM, Salem HK (2015) Cryptorchidism and Fertility. Clin Med Insights Reprod Health 22(9):39–43. https://doi.org/10.4137/CMRH.S25056. (PMID:26740750 PMCID:PMC4689328)

    Article  Google Scholar 

  3. Jia H, Ma T, Jia S, Ouyang Y (2021) AKT3 and related molecules as potential biomarkers responsible for cryptorchidism and cryptorchidism-induced azoospermia. Transl Pediatr 10(7):1805–1817. https://doi.org/10.21037/tp-21-31

    Article  PubMed  PubMed Central  Google Scholar 

  4. Christensen AK, Mason NR (1965) Comparative Ability of Seminiferous Tubules and Interstitial Tissue of Rat Testes to Synthesize Androgens from Progesterone-4-14c in Vitro. Endocrinology 76:646–656

    Article  CAS  PubMed  Google Scholar 

  5. Zirkin BR, Papadopoulos V (2018) Leydig cells: formation, function, and regulation. Biol Reprod 99(1):101–111. https://doi.org/10.1093/biolre/ioy059

    Article  PubMed  PubMed Central  Google Scholar 

  6. Thorup J, Cortes D (2019) Surgical management of undescended testis - timetable and outcome: a debate. Sex Dev Genet Mol Biol Evol Endocrinol Embryol Pathol Sex Determ Differ 13(1):11–19

    Google Scholar 

  7. Kolon TF, Herndon CD, Baker LA, Baskin LS, Baxter CG, Cheng EY, Diaz M, Lee PA, Seashore CJ, Tasian GE, Barthold JS, Assocation AU (2014) Evaluation and treatment of cryptorchidism: AUA guideline. J Urol 192(2):337–345. https://doi.org/10.1016/j.juro.2014.05.005

    Article  PubMed  Google Scholar 

  8. Braga LH, Lorenzo AJ, Romao RLP (2017) Canadian Urological Association-Pediatric Urologists of Canada (CUA-PUC) guideline for the diagnosis, management, and followup of cryptorchidism. Can Urol Assoc J Journal de l’Association des Urologues du Canada 11(7):E251–E260. https://doi.org/10.5489/cuaj.4585

    Article  PubMed  Google Scholar 

  9. Radmayr C, Dogan HS, Hoebeke P, Kocvara R, Nijman R, Silay S, Stein R, Undre S, Tekgul S (2016) Management of undescended testes: European Association of Urology/European Society for Paediatric Urology Guidelines. J Pediatr Urol 12(6):335–343. https://doi.org/10.1016/j.jpurol.2016.07.014

    Article  PubMed  Google Scholar 

  10. Wang YJ, Chen L, Zhang QL, Lin Y, Cui X, Chen JC et al (2020) Transscrotal transverse incision for the treatment of middle and low cryptorchidism in children: experience from 796 cases. BMC Surg 20(1):51

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jan IA, Hassan M, Shalaan I, Alshehhi MA (2021) Single Median Raphe Scrotal incision Orchiopexy: a safe & feasible approach for fixation of Palpable Undescended testes. Pak J Med Sci 37(7):1930–1934

    Article  PubMed  PubMed Central  Google Scholar 

  12. Feng S, Yang H, Li X, Yang J, Zhang J, Wang A et al (2016) Single scrotal incision orchiopexy versus the inguinal approach in children with palpable undescended testis: a systematic review and meta-analysis. Pediatr Surg Int 32(10):989–995

    Article  CAS  PubMed  Google Scholar 

  13. Annandale T (1879) Case in which a testicle congenitally displaced into the perinaeum was successfully transferred to the scrotum. BMJ 1(940):7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Canavese F, Mussa A, Manenti M et al (2009) Sperm count of young men surgically treated for cryptorchidism in the first and second year of life: fertility is better in children treated at a younger age. Eur J Pediatr Surg 19:388–391

    Article  CAS  PubMed  Google Scholar 

  15. Pettersson A, Richiardi L, Nordenskjold A et al (2007) Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 356:1835–1841

    Article  CAS  PubMed  Google Scholar 

  16. Zvizdic Z, Milisic E, Halimic A, Zvizdic D, Zubovic SV (2014) Testicular volume and testicular atrophy index as predictors of functionality of unilaterally cryptorchid testis. Med Arch 68(2):79–82

    Article  PubMed  PubMed Central  Google Scholar 

  17. Yang M, Wen S, Lin T, Liu X, Zhang DY, Liu F et al (2022) Diagnosis, treatment, outcome, and reasons for delayed treatment of cryptorchidism with torsion in children: a 16-year retrospective study in a large pediatric medical center. Asian J Androl 24(4):386–389

    Article  PubMed  Google Scholar 

  18. Goulis DG, Tsametis C, Iliadou PK, Polychronou P, Kantartzi PD, Tarlatzis BC et al (2009) Serum inhibin B and anti-Mullerian hormone are not superior to follicle-stimulating hormone as predictors of the presence of sperm in testicular fine-needle aspiration in men with azoospermia. Fertil Steril 91(4):1279–1284

    Article  CAS  PubMed  Google Scholar 

  19. Cortes D, Clasen-Linde E, Hutson JM, Li R, Thorup J (2016) The Sertoli cell hormones inhibin-B and anti Mullerian hormone have different patterns of secretion in prepubertal cryptorchid boys. J Pediatr Surg 51(3):475–480

    Article  PubMed  Google Scholar 

  20. Weintraub A, Eldar-Geva T (2017) Anti-Mullerian Hormone (AMH) Determinations in the Pediatric and Adolescent Endocrine Practice. Pediatr Endocrinol Rev PER 14(4):364–370

    PubMed  Google Scholar 

  21. Kollin C, Karpe B, Hesser U et al (2007) Surgical treatment of unilaterally undescended testes: testicular growth after randomi- zation to orchiopexy at age 9 months or 3 years. J Urol 178:1589–1593

    Article  PubMed  Google Scholar 

  22. Coughlin MT, Bellinger MF, Lee PA (1999) Age at unilateral orchiopexy: effect on hormone levels and sperm count in adult- hood. J Urol 162:986–988

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge the Provincial Health Special Subsidy Project of Fujian Provincial Finance Department ((2020)467). The knowledge obtained from this study is expected to have a crucial impact on refining the approach to cryptorchidism management and ultimately improving patient outcomes.

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical University, 18 Daoshan Road, Fuzhou, Fujian, China

    Wenhua huang, Xu Cui & Chaoming Zhou

  2. Department of Urinary Surgery, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children’s Hospital, Fujian Medical University, Fujian, China

    Longyao Xu, Shushen Chen & Zhiqiang Chen

Authors
  1. Wenhua huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Longyao Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shushen Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhiqiang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xu Cui
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chaoming Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

WH, LY, and CM contributed to conception and design of the study. SS organized the database. ZQ and XC performed the statistical analysis. WH wrote the first draft of the manuscript. WH, LY, and CM wrote sections of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version. To Provincial health special subsidy project of Fujian Provincial Finance Department (20,202,616).

Corresponding author

Correspondence to Chaoming Zhou.

Ethics declarations

Conflict of interest

No conflict of interest exists in the submission of this manuscript, and this manuscript is approved by all authors for publication. I would like to declare on behalf of my coauthors that the work described was original research that has not been published previously, and is not under consideration for publication elsewhere, in whole or in part. All the authors listed have approved the manuscript that is enclosed.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

huang, W., Xu, L., Chen, S. et al. Evaluating testicular function changes in unilateral cryptorchid chinese infants underwent orchidopexy in the first year of life. Int Urol Nephrol 56, 1537–1542 (2024). https://doi.org/10.1007/s11255-023-03896-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-023-03896-4

Keywords

Search

Navigation