Testicular and sexual function in adults with prune belly syndrome

Testicular and sexual function was investigated in 9 patients between 16 and 28 years old with prune belly syndrome. At personal interview all patients claimed to experience normal erections and orgasm but 7 had retrograde ejaculation. Examination showed a normally developed male habitus. Orchiopexies had been performed in late childhood or adolescence. Two patients were anorchic and the surviving testicles were small in the remaining 7. Serum testosterone was low in 1 patient and normal in 6 but at the expense of high luteinizing hormone levels in 4. All patients had a high serum follicle-stimulating hormone level, reflecting the azoospermia found in 5 patients tested. Three biopsies from atypical cases showed poor histological findings but 2 revealed early spermatogenesis. The testes in patients with prune belly syndrome are similar to undescended testes in otherwise normal men. Late orchiopexy produces sexually active but infertile men.