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The retractile testis can be a cause of adult infertility
M Caucci1, G Barbatelli, S Cinti
1G. Salesi Children's Hospital, Ancona, Italy.
Objective:
To determine the functional state of the testes of young adults treated for small and hypotrophic retractile testis at prepubertal age by orchiopexy and/or hormonal therapy and the functional state of the testes of adults with retractile testis.
Design:
Spermiogram and transmission electron microscopy (TEM) study of the semen. Light microscopic and TEM studies of semen and testicular biopsies of adult with retractile testis were performed.
Setting:
Division of Pediatric Surgery in an academic environment.
Patient(S):
Thirty-eight young adults (mean age, 18 years) treated for retractile testis at prepubertal age and seven adults (mean age, 28 years) with retractile testis.
Intervention(S):
Two cycles of hCG, followed by surgical therapy (orchiopexy) when unsuccessful.
Main Outcome Measure(S):
Fertility of young adults treated for retractile testis at prepubertal age.
Result(S):
Only 8 of 38 (21%) young adults had normal spermiograms. Five of 38 (13%) were azoospermic and 25 of 38 (66%) were oligoasthenozoospermic with ultrastructural signs of altered maturation of the sperm and a higher number of atypical forms. Of the adults with retractile testis, 2 of 7 (28.5%) were normal, 3 of 7 (43%) were oligoasthenozoospermic, and 2 of 7 (28%) were azoospermic.
Conclusion(S):
Our data support the hypothesis that prepubertal retractile testis showing signs of reduced consistency and size is a risk factor for adult infertility and requires treatment.