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Evaluating testicular function changes in unilateral cryptorchid chinese infants underwent orchidopexy in the first
Wenhua Huang1, Longyao Xu2, Shushen Chen2
1Department 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.
Insights
Early orchiopexy for cryptorchidism improves testicular growth and function in infants. However, full recovery to healthy peer levels may take longer, emphasizing the need for prompt surgical intervention.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Urology
Background:
- Cryptorchidism management aims to maximize fertility potential, typically by 18 months of life.
- Longitudinal postoperative data for Chinese infants undergoing cryptorchidism repair is limited.
- Early surgical intervention is crucial for optimal testicular development and function.
Purpose of the Study:
- To evaluate changes in testicular function after orchiopexy in Chinese infants within the first year of life.
- To assess the impact of early surgical management on hormonal levels and testicular volume.
- To compare postoperative outcomes with age-matched healthy controls.
Main Methods:
- Prospective enrollment of 51 infants with unilateral inguinal cryptorchidism undergoing orchiopexy.
- Serial measurements of anti-Mullerian hormone (AMH), inhibin B (InhB), testosterone (T), testicular volume, and testicular atrophy index (TAI).
- Data collection at baseline, 6 months, and 1 year post-surgery, with comparison to 42 healthy controls.
Main Results:
- Testicular volume and AMH levels significantly increased post-surgery but remained lower than controls.
- Inhibin B levels significantly increased, surpassing controls at 6 months post-surgery.
- Testicular atrophy index (TAI) was 16.7% at 6 months and 8.6% at 12 months.
Conclusions:
- Orchiopexy improves testicular growth and function in infants with cryptorchidism.
- Full restoration of testicular function to peer levels may require extended recovery time.
- Addressing cryptorchidism at the earliest opportunity is recommended to optimize testicular function recovery.
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.
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