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[Testicular function after spermatic cord torsion]

T Ichikawa1, N Kitagawa, Y Shiseki

  • 1Department of Urology, School of Medicine, Chiba University.

Hinyokika Kiyo. Acta Urologica Japonica
|March 1, 1993
PubMed
Summary

Bilateral orchiopexy preserves semen quality and endocrine function after spermatic cord torsion. Orchiectomy can lead to decreased testicular function and abnormal semen parameters, especially in older patients.

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Area of Science:

  • Urology
  • Reproductive Medicine
  • Andrology

Context:

  • Spermatic cord torsion is a surgical emergency affecting testicular viability.
  • Assessing long-term reproductive outcomes after torsion management is crucial.
  • Treatment options include orchiopexy and orchiectomy, with varying implications for fertility.

Purpose:

  • To investigate the impact of different surgical treatments for spermatic cord torsion on semen quality and endocrine parameters.
  • To compare outcomes between bilateral orchiopexy and ipsilateral orchiectomy with contralateral orchiopexy.
  • To identify factors influencing post-torsion testicular function.

Summary:

  • Patients undergoing bilateral orchiopexy maintained normal semen quality and endocrine profiles.

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  • The orchiectomy group showed significantly lower sperm density, total sperm count, and higher follicle-stimulating hormone levels.
  • Long-term follow-up revealed persistent oligozoospermia or azoospermia in a subset of the orchiectomy group, particularly older patients.

    • Impact:

    • Early surgical intervention with bilateral orchiopexy is associated with preserved testicular function and normal semen quality.
    • Ipsilateral orchiectomy may result in reduced testicular function, with age at operation being a potential risk factor for poorer outcomes.
    • Findings underscore the importance of timely and conservative surgical management for optimizing fertility potential after spermatic cord torsion.