| Abstract [eng] |
This is the first Lithuanian research analyzing the relationship between Ad spermatogonia in testicular biopsies and the patient’s age at orchopexy. The aim of the study was to estimate the most relevant time for surgical management of cryptorchidism. Ad spermatogonia have been chosen as a major histological factor reflecting normal testicular maturation and fertility. Efforts were put to evaluate correlation between the former criterion and the age at orchopexy to define age impact at orchopexy to fertility potential in cryptorchid boys. There is still no consensus on the optimal age of orchopexy. In our opinion, preservation of testicular germ cell maturation is facilitated by early operation. Infertility risk degree can be determined by testicular sampling during orchopexy. Early orchopexy increases fertility chances. In the main text of the research we have comprehensively described standardized testicular sampling technique which was used during the process of the research. The number of Lithuanian boys who undergo orchopexy has been recently increasing. Average age at orchopexy during the last decade has decreased by 1,83 years. Difference between spermatogonia detected in boys younger than 14 months was significantly higher than in boys up to 3 years. A negative correlation has been detected between the age and Ad spermatogonia. TFI was significantly higher in the first age group. Testicular position had no significant influence to TFI. Medium infertility risk group was more frequent in the first group, while high infertility risk group in the second. In the second group rate of chance has demonstrated that boys of this group can have doubled risk of high infertility. The development of germ cells, reflected by the presence of Ad spermatogonia is moreover related to testicular position and epidymal adhesion in cryptorchid testis. The development of Ad spermatogonia as a result of mini-puberty has a relationship with epididymal-testicular adhesion variant. In summary, results suggest early orchopexy up to 1 year of age. In particular cases pharmacological treatment with LH-RH analogues should be considered. |
