Sexual development in adolescents after surgical treatment for cryptorchidism

Objective To investigate the sexual development in adolescents after surgical treatment for undescended testes. Methods A total of 166 adolescents underwent surgery for cryptorchidism before age of 10 years.They were divided into 2 groups according to surgical methods,ie,orchiectomy group and orchiopexy group;for the latter,they were subdivided into 5-year group and ≥ 5-year group according to the age at operation.In addition,within the same age range,22 cases of unilateral undescended testes receiving no surgery and 25 normal controls were also included.Postoperatively,the pubic hair stage,natural length and girth of penis,mean volume of testes (MTV),serum luteinizing hormone (LH),follicle-stimulating hormone (FSH) and testosterone (T) levels were examined to find out the effects of age at operation, location of testis and operative methods on prognosis. Results MTV (ml) of unilaterally undescended testes was significantly smaller than the normally descended contralateral gonad(15.5±2.4 vs 8.1±2.1)in adolescents undergoing unilateral orchiopexy,but larger than that in untreated group (4.0±2.0) .FSH level (mIU/ml) was significantly higher in adolescents undergoing orchiopexy and orchiectomy (4.5±1.7 and 6.2±1.8,respectively) than that in controls (2.4±1.1);and it was shown that those undergoing orchiectomy presented significantly higher FSH levels than orchiopexy.Pubic hair stage,lengths and girth of penis,MTV and T were significantly greater and higher,but FSH was lower in those treated before age 5 years than those at 5 years or older.The testicular volume was significantly decreased, while FSH was significantly increased in those with intra-abdominal testes.Negative correlation was found between FSH and testicular volume (r= -0.291, P 0.05). Conclusions Leydig cell function seems relatively resistant to the hostile environment of the cryptorchidism.Early diagnosis and surgical management of the undescended testicle can preserve fertility.