[Influence of different treatments of unilateral testicular torsion on the long-term fertility of the patient].

ABSTRACT

OBJECTIVE: To evaluate the effects of different treatments of unilateral testicular torsion on the long-term fertility of the patient. METHODS: We reviewed the clinical and fertility-related follow-up data on 92 cases of unilateral testicular torsion treated by orchiectomy (the OE group, n = 49) or orchiopexy (the OP group, n = 43) between January 2000 and December 2014. We compared the testis volume, semen parameters, reproductive hormone indexes, natural pregnancy rate (NPR) and time to pregnancy (TTP) between the two groups, and analyzed the influence of orchiectomy and orchiopexy on the fertility of the patients. RESULTS: Totally, 77 of the men met the inclusion criteria and included in this study, 40 in the OE and 37 in the OP group. Follow-up data exhibited no statistically significant difference between the two groups of patients in the age of marriage, mean frequency of intercourse or sexual function. The men in the OE group, compared with those in the OP group, showed a larger volume of the opposite testis (ï¼»17.62 ± 2.15ï¼½ vs ï¼»16.86 ± 2.05ï¼½ ml, P > 0.05), but lower semen volume (ï¼»4.09 ± 0.89ï¼½ vs ï¼»4.11 ± 0.76ï¼½ ml, P > 0.05), sperm concentration (ï¼»27.60 ± 7.58ï¼½ vs ï¼»27.74 ± 6.80ï¼½ ×106/ml, P > 0.05), sperm motility (ï¼»60.14 ± 14.50ï¼½% vs ï¼»60.29 ± 16.36ï¼½%, P > 0.05), and percentages of progressively motile sperm (PMS) (ï¼»38.37 ± 10.88ï¼½% vs ï¼»38.82 ± 9.73ï¼½%, P > 0.05) and morphologically abnormal sperm (MAS) (ï¼»29.80 ± 7.29ï¼½% vs ï¼»29.55 ± 7.03ï¼½%, P > 0.05), lower levels of FSH (ï¼»8.01 ± 2.31ï¼½ vs ï¼»8.12 ± 2.63ï¼½ IU/L, P > 0.05), LH (ï¼»15.05 ± 4.20ï¼½ vs ï¼»15.46 ± 4.76ï¼½ IU/L,P > 0.05) and T (ï¼»19.06 ± 3.60ï¼½ vs ï¼»19.46 ± 4.02ï¼½ nmol/L, P > 0.05), lower NPR (75.0% ï¼»30/40ï¼½ vs 83.8% ï¼»31/37ï¼½, P > 0.05) and longer TTP (ï¼»18.0 ± 5.7ï¼½ vs ï¼»14.6 ± 3.8ï¼½ mo, P > 0.05). CONCLUSIONS: For patients with unilateral testicular torsion, orchiectomy achieved a lower semen quality and NPR and a longer TTP than orchiopexy, but induced no significant fertility decrease. Detorsion of the torsioned testis little affects the fertility of the patient.