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J Urol. 2007 Oct;178(4 Pt 2):1589-93; discussion 1593. Epub 2007 Aug 16.

Surgical treatment of unilaterally undescended testes: testicular growth after randomization to orchiopexy at age 9 months or 3 years.

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  • 1Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden. claude.kollin@karolinska.se

Abstract

PURPOSE:

We compared the growth of congenital, unilaterally undescended testes following orchiopexy at age 9 months or 3 years.

MATERIALS AND METHODS:

Patients were randomized to surgery at age 9 months (72) or 3 years (83). Testicular volume was measured by ultrasonography at ages 6, 12, 24, 39 and 48 months.

RESULTS:

Orchiopexy at age 9 months resulted in an increase in testicular volume at subsequent measurements at ages 2, 3 and 4 years compared to the volume at 6 months (p <0.001). In contrast, no significant growth was noted in the group treated at age 3 years. The improved testicular growth after early orchiopexy was also demonstrated by a gradual increase in the ratio of the previously retained testis and the scrotal testis in individual boys from 6 months to 4 years (0.68 to 0.81, p <0.001). For the late treatment group a significant decrease in this ratio was noted during the same period (0.68 to 0.56, p <0.01).

CONCLUSIONS:

Surgical treatment at 9 months resulted in partial catch-up of testicular growth until at least age 4 years compared to surgery at 3 years, clearly indicating that early surgery has a beneficial effect on testicular growth. Since testicular volume is an approximate indirect measure of spermatogenic activity, this gives hope that orchiopexy at this age may improve future spermatogenesis.

PMID:
17707045
DOI:
10.1016/j.juro.2007.03.173
[PubMed - indexed for MEDLINE]
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