Evaluating testicular function changes in unilateral cryptorchid chinese infants underwent orchidopexy in the first year of life.

OBJECTIVE: Management of cryptorchidism is typically recommended within the first 18 months of life to maximize fertility potential. However, there is a paucity of longitudinal postoperative data for Chinese infants. We aim to evaluate the Testicular function change when the procedure is done within the first year of life. METHOD: We prospectively enrolled 51 children diagnosed with unilateral inguinal cryptorchidism into the surgical group between January 2021 and January 2022. Orchidopexy was carried out through a single transverse scrotal incision. Assessments of anti-Mullerian hormone (AMH), inhibin B (InhB), testosterone (T) levels, testicular volume and testicular atrophy index (TAI) were conducted at baseline, 6 months, and 1 year following surgery. Concurrently, clinical data from 42 healthy age-matched controls were collected during their routine physical examinations. RESULTS: At 6- and 12-months post-surgery, testicular volume increased significantly to 0.98 ± 0.12 mL and 1.01 ± 0.12ml. AMH levels also rose from 76.40 ± 15.77 ng/mL to 81.52 ± 15.32 ng/mL and 87.50 ± 15.36 ng/mL. However, these parameters are significantly lower than age-matched healthy controls (both P < 0.001). InhB levels significantly increased after surgery and even surpassed those of healthy controls after 6 months (both P < 0.001). The TAI was 16.7% and 8.6% at 6- and 12-months following surgery. CONCLUSION: Although orchiopexy can improve testicular growth and function, the restoration of testicular function to the level of healthy peers might take longer. To expedite the recovery of testicular function and bring it in line with that of peers, we recommend addressing cryptorchidism at the earliest opportunity.

Efficacy of various surgical approaches in treating hematospermia using transurethral seminal vesiculoscopy.

PURPOSE: To explore the efficacy of different approaches of seminal vesiculoscopy surgery and the predictive factors of good treatment outcome. MATERIALS AND METHODS: A retrospective analysis of 68 patients who underwent seminal vesiculoscopy for hematospermia in our hospital from January 2015 to January 2021. According to different surgical approaches, they were divided into three groups: natural ejaculatory ducts (method A, 45 cases), assisted transurethral resection/incision of ejaculatory ducts (method B, 14 cases), fenestration in prostatic utricle (method C, 9 cases). We analyzed the recurrence rate of the three surgical approaches and the predictive factors of treatment efficacy. RESULTS: The total recurrence rate after the seminal vesiculoscopy for hematospermia in this group was 32.35%. The postoperative recurrence rates of the three methods were 24.44% for method A, 50.00% for method B and 44.44% for method C, and there was no significant difference among the three methods (P > 0.05). The data of five predictors of 45 cases in method A group were included in the Univariate Logistic analysis, the results suggest that whether complicated with seminal tract stones/cysts was an effective predictor (OR 0.250, P = 0.022), which was still an effective predictor in the Multivariate Logistic analysis model (OR 0.244, P = 0.010). CONCLUSIONS: The Transurethral seminal vesiculoscopy technique demonstrates a low postoperative recurrence rate in treating hematospermia. Among the various approaches, the intraoperative use of natural orifices through the ejaculatory duct exhibits the lowest recurrence rate. Additionally, seminal tract stones/cysts effectively predict favorable postoperative outcomes.

The effect of scrotal versus inguinal orchiopexy on the testicular function of children with clinically palpable, inguinal undescended testis: a randomized controlled trial.

To compare the impact of the scrotal vs inguinal orchidopexy approach on the testicular function of infants with cryptorchidism, a randomized controlled trial was conducted involving boys who were 6-12 months old at surgery and were diagnosed with clinically palpable, inguinal undescended testis. Between June 2021 and December 2021, these boys at Fujian Maternity and Child Health Hospital (Fuzhou, China) and Fujian Children's Hospital (Fuzhou, China) were enrolled. Block randomization with a 1:1 allocation ratio was employed. The primary outcome was testicular function assessed by testicular volume, serum testosterone, anti-Müllerian hormone (AMH), and inhibin B (InhB) levels. Secondary outcomes included operative time, amount of intraoperative bleeding, and postoperative complications. Among 577 screened patients, 100 (17.3%) were considered eligible and enrolled in the study. Of the 100 children who completed the 1-year follow-up, 50 underwent scrotal orchidopexy and 50 underwent inguinal orchidopexy. The testicular volume, serum testosterone, AMH, and InhB levels in both groups increased markedly after surgery (all P < 0.05), but there were no apparent differences between groups at 6 months and 12 months after operation (all P > 0.05). No differences between the scrotal and inguinal groups were noted regarding the operative time ( P = 0.987) and amount of intraoperative bleeding ( P = 0.746). The overall complication rate (2.0%) of the scrotal group was slightly lower than that of the inguinal group (8.0%), although this difference was not statistically significant ( P > 0.05). Both scrotal and inguinal orchiopexy exerted protective effects on testicular function in children with cryptorchidism, with similar operative status and postoperative complications. Scrotal orchiopexy is an effective alternative to inguinal orchiopexy in children with cryptorchidism.