Stimulation of Spermatogenesis and Synthesis of Testosterone by Allotransplantation of Neonatal Testicular Tissue under Tunica Albuginea of Cryptorchid Testis.

The abdominal type of cryptorchism was modeled on random-bred albino rats by replacing both testes from the scrotum into the abdominal cavity for 3 weeks; thereupon they were manipulated into the scrotum. In control rats, no additional surgery was performed. In experimental rats, the testicular tissue obtained from 1-2-day rat pups was transplanted under testicular tunica albuginea. Prior to orchiopexy, the weight of testes decreased by 62.5-64.1%. In 6 month after the surgery, it increased by 36.1% in the control group, whereas in experimental rats the weight of testes elevated by 123.2% and approximated the normal value. Histologically, the control group demonstrated persistent disturbance in spermatogenesis with emptiness of numerous seminiferous tubules where only Sertoli cells could be revealed and with pronounced dystrophic alterations in the spermatogenous epithelium of the partially preserved tubules where spermatogenesis was blocked at the spermatogonial level. In contrast, the transplantation region of the experimental testes exhibited formation of novel mature testicular tissue enclosed by a connective tissue capsule incorporating the seminiferous tubules with differentiated epithelium and with the clusters of Leydig cells in the stroma. In 6 month, spermatogenesis was observed in most seminiferous tubules of the host testicular tissue, which had spermatozoa in the lumens. To the moment of orchiopexy, the blood testosterone decreased by about 2.5-fold. In control group it remained diminished during entire observation period (up to 6 month), while in the experiment group its level normalized completely as early as in 2 month and remained even elevated to the end of observation period.

Innovative method of diagnostics abdominal forms of cryptorchism at the children for prevention of infertility.

OBJECTIVE: Introduction: Topicability of this problem is caused by well-spread of cryptorchism among children: from 2-3% at newborn boys in UK to 10-12% of newborn boys in the Post Soviet Union countries. Degenerative processes, occured in testicle could lead to the development of eunuchoidism, feminization, gynecomastia, infantilism. In the future, changes in seminiferous epithelium contribute to the development of male infertility, impotence and malignant tumors - seminoma, teratoblastoma. PATIENTS AND METHODS: The aim: To improve diagnosis for abdominal forms of cryptorchism at the children through implementation innovative methods in practice (laparoscopic diagnostics). Materials and methods: For a period from 2014 to 2017 years were carried out 43 diagnostic laparoscopy of non palpated testicle syndrome. By age children were distributed into the following groups: up to 1 year -18 children, 1-2 years - 25 children. RESULTS: Results: Analyzing results of our research there is no doubt that laparoscopy is one of the most reliable methods of diagnosis abdominal cryptorchism in children. This method allows both to determine location of a damaged testicle in the abdominal cavity, but also to assess its condition, developed further tactics of treatment. CONCLUSION: Conclusions: Laparoscopic diagnosis abdominal forms of cryptorchism is the most reliable method in a comparison with computed tomography, ultrasound, radioisotope studies. Procedure of laparoscopic diagnosis could show not only location and condition of the testis, blood vessels and ductus deferens, but help to develop the further treatment tactics.

Analgesia use during pregnancy and risk of cryptorchidism: a systematic review and meta-analysis.

STUDY QUESTION: Are boys who are born to mothers who use analgesics during pregnancy at increased risk of cryptorchidism compared to those born to mothers who do not take analgesia? SUMMARY ANSWER: In this systematic review and meta-analysis of 10 published studies, we observed only weak evidence of an association between analgesia use during pregnancy and risk of cryptorchidism in the son. WHAT IS KNOWN ALREADY: Concentrations of analgesia relevant to human exposure have been implicated as causing endocrine disturbances in the developing foetal testis. However, when viewed collectively there appears to be conflicting evidence regarding an association between maternal use of analgesics and development of cryptorchidism. STUDY DESIGN, SIZE, DURATION: A systematic review and meta-analysis of studies on analgesia use during pregnancy and risk of cryptorchidism was performed. The search terms used were (analges* OR paracetamol OR acetaminophen) AND (cryptorchidism OR cryptorchism OR undescended test* OR non-descended test* OR non descended test*) for the databases Ovid Medline, Embase, Scopus and Web of Science. The search included all published articles up until 23 May 2016 and no limits were set in terms of language. PARTICIPANTS/MATERIALS, SETTING, METHODS: Abstracts were screened by one reviewer to remove irrelevant studies, with a 10% random sample of these verified by a second reviewer. The full text of all remaining papers was assessed by two reviewers. Abstracts included in the final analysis were studies which reported associations between the exposure (analgesia) and the outcome (cryptorchidism). Studies were only included if data were provided from which summary associations (odds ratios (ORs) or relative risks) and their 95% CIs could be calculated, or if summary associations were provided by the authors themselves. For each included study, two reviewers independently extracted study meta-data in line with PRISMA recommendations. We assessed study quality and potential for bias using the criteria outlined in the Newcastle-Ottawa Quality Assessment Scale, but did not determine a quality score. Two reviewers independently assessed study quality against these criteria. MAIN RESULTS AND THE ROLE OF CHANCE: After screening 350 manuscripts, 10 were included in our review (5 case-control studies, 5 cohort studies). We observed weak evidence of an association between ever use of analgesia and risk of cryptorchidism (pooled crude OR: 1.11, 95% CI: 1.00-1.23), with case-control studies revealing a marginally stronger association (1.23, 95% CI: 0.85-1.78) than cohort studies (1.09, 95% CI: 0.97-1.22). We observed weak evidence of a dose-response relationship between increasing weeks of analgesia exposure and risk of cryptorchidism, as well as weak evidence of an effect of timing on analgesia exposure and risk of cryptorchidism. Assessment of study quality via the Newcastle-Ottawa criteria revealed little (if any) evidence of substantial bias that may have meaningfully affected a given study's results. LIMITATIONS, REASONS FOR CAUTION: While confounding does not appear to be important, misclassification of the exposure is possibly an important source of measurement error in this context. The systematic review is open to reporting bias. Owing to scant data, no meta-analyses for two key questions (relating to dose-response and timing of exposure) could be performed. Medications were grouped based on their common effect and this offers little insight into the relation between specific types of analgesia and cryptorchidism. Finally, there are limitations in assuming that analgesia use reported by mothers is synonymous with actual intrauterine exposure. WIDER IMPLICATIONS OF THE FINDINGS: The ubiquity of analgesia use during pregnancy makes this exposure particularly important from a population health perspective. About 9 of the 10 studies were conducted in Europe or USA, limiting generalizability of our observations. While the observations from our systematic review and meta-analysis suggest that analgesia use during pregnancy is not strongly associated with cryptorchidism development in the son, they also highlight the need for further detailed assessments of this relationship. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by the Health Research Council of New Zealand (reference #: 14/052). The authors have no conflict of interest to declare. REGISTRATION NUMBER: CRD42016041414.

[Undescended testis: current treatment guidelines]. / Hodenhochstand: aktuelle Therapierichtlinien.

BACKGROUND: Cryptorchidism is the most common genital malformation in male newborns. In recent years, guidelines concerning diagnosis and therapy have undergone considerable evolution with the implementation of recent knowledge in pathophysiology, diagnosis, and therapy. OBJECTIVES: The aim of this publication is to provide an overview of the current national and international guideline recommendations concerning diagnosis and treatment of cryptorchidism. Critical points are discussed in light of current scientific literature. MATERIALS AND METHODS: The current guidelines of the European Association of Urology (EAU)/European Society for Pediatric Urology (ESPU), the American Association of Urology (AUA), the pediatric urologic task force of the Austrian Society of Urology (ÖGU), the international consultation on urological disease (ICUD) and the German Society of Urology (DGU)/German Association of Pediatric Surgery (DGKCh) have been analyzed concerning the most important aspects of treatment and diagnosis. RESULTS: There is broad consensus concerning most steps and decisions for the treatment of cryptorchidism. However, some aspects of diagnostic imaging, the use of hormonal therapy, and surgical access in nonpalpable testis warrant further discussion and are the fields of considerable changes.

UNDESCENDED TESTIS: A STUDY OF 50 CASES.

Fifty consecutive cases of undescended testis treated at a service hospital over a period of 3 years from January 1993 to December 1995 were studied. Only 2 patients (4%) were below the age of 2 years and 25 (50%) were past the age of 15 years. Two cases presented with seminoma in intraobdominal testis. Ultrasonography was found unreliable in localizing the impalpable testis. Subdartos pouch orchiopexy (Winsburry-White) was the definitive procedure adopted in 21 out of the 25 orchiopexies performed and the results were good. Orchidectomy seems the best option of treatment in post-pubertal patients with unilateral symptomatic maldescent.

Spontaneous sertoli cell tumor with cryptorchism in a beagle dog.

A male one year-old beagle dog with unilateral cryptorchism was presented for investigation of reduced appetite. Abdominal sonography and radiography demonstrated abnormal enlargement of the left testicle in the abdominal cavity. Both the retroperitoneal cryptorchid testicle and the other contralateral testicle were removed surgically. The retroperitoneal cryptorchid testicle was an enlarged, firm and bulging sphere mass. The cut surface revealed a homogeneous white color. The contralateral testicle in the scrotum showed an almost normal appearance. Histopathologically, the retroperitoneal cryptorchid testicle was diagnosed as a Sertoli cell tumor. This report describes a case of Sertoli cell tumor with cryptorchism in a beagle dog.

Spontaneous Sertoli Cell Tumor with Cryptorchism in a Beagle Dog / 한국실험동물학회지

A male one year-old beagle dog with unilateral cryptorchism was presented for investigation of reduced appetite. Abdominal sonography and radiography demonstrated abnormal enlargement of the left testicle in the abdominal cavity. Both the retroperitoneal cryptorchid testicle and the other contralateral testicle were removed surgically. The retroperitoneal cryptorchid testicle was an enlarged, firm and bulging sphere mass. The cut surface revealed a homogeneous white color. The contralateral testicle in the scrotum showed an almost normal appearance. Histopathologically, the retroperitoneal cryptorchid testicle was diagnosed as a Sertoli cell tumor. This report describes a case of Sertoli cell tumor with cryptorchism in a beagle dog.

Clinical Observation on lntrascrotally Impalpable Testis / 대한비뇨기과학회지

A clinical observation was made on 177 cases of intrascrotally impalpable testis seen in the Department of Urology, Seoul National University Hospital during the period from January. 1979. The following results were obtained: 1. Only 53 cases (29.9%) visited hospital in the preschool age and 165 cases(93.2%) before the age of 25. 2. ll4 cases (64.4%) had unilateral involvement and right site was more frequently affected. Bilaterality was noted in 63 cases (35.6%). 3. 237 testes were surgically explored and hernial sac was found in l91 explorations (80.6%). 4. Among 237 explorations, 4 cases were confirmed as monorchism and inguinal canal was the most frequent site of testicular retention (78.5%). 5. Chromosome study was done on 7 cases and all cases yielded 46 XY, cytogenetically normal male. 6. Semen analysis was performed on 20 postpuberal cases and all 13 cases of bilateral intrascrotally impalpable testis revealed azoospermia. In 7 cases of unilateral intrascrotally impalpable testis 3 cases were within normal limits and 4 cases showed oligospermia. 7. Surgical specimens were obtained from 29 cases and l case turned out to be seminoma. Pathologic findings of 28 cases excluding seminoma were evaluated on the basis of basement membrane thickening, peritubular fibrosis, Leydig cell hyperplasia and spermatogenic activity. 8. Treatment consisted of pre-or post-operative HCG injection in the dosage of 2,500 to l0,000 IU on 57 prepubeta1 or puberal cases and 217 orchiectomies (5.8%) and 2l7 orchiopexies (90.4%).

Clinical Observation on the Cryptorchism / 대한비뇨기과학회지

A clinical observation was made on 53 patients of cryptorchism who had been admitted to the Department of Urology, Kangnam Sacred Heart Hospital during the period from January, 1980 to January, 1983. The following results were obtained: 1. Only 22 patients (41.5%) visited hospital in preschool age (7 years old) and 50 patients (94.3%) before the age of 25. 2. 44 patients (83%) had unilateral involvement and right side (56.6%) was more frequently affected. Bilaterally was noted in 9 patients (17%). 3. 59 testes were surgically explored, 2 cases were confirmed as monorchism. Of the 59 testes, 47 (79.7%) were located in the inguinal canal, 8 (13.6%) in the prepubic region and 2(3.4%) in the abdomen. 4. Among the 59 explorations, 50 cases (84.8%) were found .the hernial sac. Other complication and associated diseases were contralateral hydrocele, ventral curvature of penis, prosis, entropion, intestinal obstruction, triology of Fallot, acute glomerulonephritis and seminoma. 5. Orchiopexy was performed on 53 testes (93%), 4 cases were performed the orchiectomy because of testicular atrophy and excessive short spermatic cord.

Clinical Observation on the Cryptorchism / 대한비뇨기과학회지

A clinical observation was made on 25 patients of cryptorchism who had been admitted to the Department of Urology, National Seoul Hospital during the 3 years period from January, 1979 to December, 1981. The following results were obtained: 1. The most frequent age group was seen at over 15 and average age was 11.2 years which means too late for requiring adequate treatment. 2. Orchiopexy was performed on 28 testis (84.9%), 4 cases were performed the orchiectomy because of atrophy or impossible placement to scrotum and histopathology revealed atrophic change, in all removed testes. 3 cases among them were proved to oligo-azoospermia by semen analysis. 3. The bilateral cryptorchisms were observed in 8 cases (32%)and inguinal type in 20 (60.6%), prepubic type in 6 (18.2%), intra-abdominal type in 4 (12.1%)and superficial inguinal type in 2 (6.1%) (12 cases in right and 5 cases in left). 4. Associated anomalies and complications were found in 11 cases (44%)and the most common anomalies were hernia, which was found in 4 cases (15.2%).

Clinical Observation on the Cryptorchism / 대한비뇨기과학회지

A Clinical observation was made on 52 patients of cryptorchism who had been admitted to the Department of Urology, Korea General Hospital during the 8 years period from June, 1972 to May, 1980. The following results were obtained : 1. Patients ranged in age from 2 to 36 years and only 19 cases (37. 3%) visited our hospital in the preschool age. 2. Bilateral cryptorchism was found in 9 cases (17.3%) and of the unilateral 43 cases, right in 19 cases, and left in 24 cases. 3. Of the 61 testes, 33 (51. 1%) were located in the inguinal canal, 13 (21.3%) in the subinguinal region and 8 (13. 1%) in the abdomen. 4. Associated diseases and complications were found in 47 cases (90. 5%) and the most common diseases were hernia, which was found in 39 cases (75. 0%). 5. Treatment consisted of preoperative HCG injection in the dosage of 5,000 to 12,000 I. U on 6 prepubertal cases and 57 orchiopexies (93.4%) and 4 orchiectomies (6. 6%).

Seminoma of the Cryptorchism / 대한비뇨기과학회지

A case of seminoma of the cryptorchism, found in 34 years old Korean male is reported. In Campbell's series, the incidence of malignancy in cryptorchism is claimed to be 35 times greater than in the normally descended testicle. A case of seminoma of the cryptorchism is added to literature.

Diagnostic Evaluation of Herniography in Cryptorchism / 대한비뇨기과학회지

Herniography is proved to be a valuable roentgenographic technique for delineating the configuration of almost all the peritoneal sacs and the position of most of the undescended testes, as well as most of the associated urologic anomalies. The authors applies this technique to thirty three boys with cryptorchism (39.4% bilateral) in this department during last 3 years and 6 months period from Jan. 1978 to June 1981. The results were as follows. 1) There were 40 open peritoneal sacs at operation, including 3 open sacs contralateral to unilateral cryptorchid testes. With the most accurate preoperative examination only 19 of these open sacs were noted (47.5%), while with herniography, 38 of the 40 were correctly identified (95.0%). 2) The position of the cryptorchid testes were accurately diagnosed by preoperative examination in 28 of the 45 instances (62.2%) With herniography we correctly located 33 testes (73.3%), despite the lack of an accompanying peritoneal sac with 8 cryptorchid testes (17.8%). 3) Associated anomalies and diseases were found in 24 instances of 33 boys, 2 of these 24 instances were discovered by the incidental pyelogram film of the herniogram to have upper urinary tract abnormalities, including one with ureteral stone and one with kidney malrotation. 4) Only 6 minor complications arose in 33 children as a result of this procedure, including 3 with abdominal injection, one with inadvertently needling of the colon, one with pain & sweating, one with transient fever. However, all of these were not troublesome for affected patients.

Diagnosis and management of impalpable testes / 中华泌尿外科杂志

Objective To review the management of impalpable testes. Methods Ninty-eight impalpable testes in 82 patients underwent surigcal exploration and all the cases were studied retrospectively. Results 17 testes were found on ultrasonography and 3 of 4 cases were found on ECT pre-operatively.Ninty-eight testes in 82 patients were explored.Eighty-five testes were found,52 in the inguinal canal,33 in the abdomen.Another 13 testes were absent.Ninty-two(94%) testes were found on inguinal exploration or limited laparotomy when necessary. Conclusions Inguinal exploration,with lower abdominal laparotomy if necessary remains the main form of management.If the testes could not be found still laparoscopy should then be performed.

Histologic findings of Cryptorchid Testis according to Age and Location / 대한비뇨기과학회지

A study on the histologic findings of cryptorchid testis according to age and location of testis was performed on 36 patients who were undergone orchiectomy or testicular biopsy among 128 cases of cryptorchidism in the Department of Urology, Chungnam National University Hospital, from January. 1984 to September, 1989. The results were as followings : 1. The age distribution of 128 patients was ranged from 2 to 30 years, and the age group of 6 to 10 years was most commonly seen(37 case, 28.9% ). Bilaterality was 17.2% (22 cases), and the ratio of right to left was 1.7:1. 2. The mean count of spermatogonia per tubule was decreased with aging in the group above the external inguinal ring, but not in the group below the external inguinal ring. 3. The mean tubular diameter of the seminiferous tubule was more increased with aging in the group below the external inguinal ring than in the group above the external inguinal ring, but smaller than normal control. 4. The thickness of basement membrane of the seminiferous tubule was more increased with aging in the group above the external inguinal ring than in the group below the external inguinal ring. 5. The mean tubular fertility index was decreased with aging in the group above the external inguinal ring, but not in the group below the external inguinal ring. From the above results, it was suggested that the cryptorchid testis would be undergone to the progressive degenerative histologic changes with aging, so our attention should be directed to early treatment at least before 2 years of age.

Histopathologic Observation on the Cryptorchism / 대한비뇨기과학회지

A histopathologic observation was made on 24 patients with cryptorchism admitted to the Department of Urology, Seoul Adventist Hospital during the periods from November 1981 to April 1983. The following results were obtained. 1. The age distribution was ranged from 2 to 28 years and 6 to 10 years of age group was the most commonly affected (9 cases, 37.5%). 2. The most common type of cryptorchidism was the inguinal type (14 cases, 58.3%). The bilateral cryptorchismswere observed in 6 cases and unilateral 18 cases, among them right in 12 cases, left in 6 Cases. 3. On the histopathologic findings of testicular biopsy in 24 cryptorchid testes; per{tubular fibrosis which began before puberty was noted the earliest finding and basement membrane of seminiferous tubules were significantly thickening during puberty. Leydig cells were increased during puberty and they became normal level after puberty but spermatogenesis were not completely observed through all the age group.

Histopathologic Observation on the Cryptorchism / 대한비뇨기과학회지

A histopathologic observation was made on 24 patients with cryptorchism admitted to the Department of Urology, Seoul Adventist Hospital during the periods from November 1981 to April 1983. The following results were obtained. 1. The age distribution was ranged from 2 to 28 years and 6 to 10 years of age group was the most commonly affected (9 cases, 37.5%). 2. The most common type of cryptorchidism was the inguinal type (14 cases, 58.3%). The bilateral cryptorchismswere observed in 6 cases and unilateral 18 cases, among them right in 12 cases, left in 6 Cases. 3. On the histopathologic findings of testicular biopsy in 24 cryptorchid testes; per{tubular fibrosis which began before puberty was noted the earliest finding and basement membrane of seminiferous tubules were significantly thickening during puberty. Leydig cells were increased during puberty and they became normal level after puberty but spermatogenesis were not completely observed through all the age group.

A Clinica1 Observation of Scrotal Disease / 대한비뇨기과학회지

Recently the scrotal diseases have been tended toward increment and take a important share in urologic disease entities. The reasons of them are thought for early reconstruction of the scrotal disease, increase of the diseases that need catheter indwelling and inclination of the scrotal injury by accident. Also up-to-date mass vasectomy have been performed for family planning, the scrotal complications have been increased. So authors report a clinical observation was made on 171 cases with scrotal disease who had been admitted to Department of Urology. E.W.U.H., Seoul, Korea, during the period from Apr. 1, 1976 through Mar. 1, 1981. The results were as follows; 1. Among 1025 cases of in-patients for past 5 years, 171 cases belong to scrotal disease giving a rate of 16.7%. 2. The most common population was 1-10 years of age giving a rate of 31.5%. 3. The most common disease was hydrocele giving a rate of 29.2%. The cryptorchism was 21%, epididymitis 15.8%, vasectomy complication 9.9%, scrotal injury 5%, sterility 4.7% and others 14.3%. 4. Of 171 cases, operation was performed in 152 cases (88.9%). 5. Most common operation was hydrocelectomy (27%), orchiopexy (19.1%), epididymectomy (9.9%) and incision and drainage (7.3%) in order.

A Case of Rt. Renal Agenesis Combined with Cryptorchism and Neuroblastoma

Congenital unilateral renal agenesis is a rare congenital anomaly. Furthermore, renal agenesis associated with neuroblastoma and cryptorchism is more rare in incidence. Recently we experieced a case of Rt. renal agenesis combined with cryptorchism and neuroblastoma. We diagnosed it with IVP and selective renal angiography and confirmed it with explolaparotomy and biopsy. We reviewed the literatures on renal agenesis, cryptorchism and neuroblastoma, and discussed possible embryological relationships between them and other combined congenital anomalies.