Correlation between testicular volume and histological findings in children with unilateral cryptorchidism: Potential impact on future fertility

Abstract

Objectives: Our aim is to assess the correlation between testicular volume and histological findings in children with unilateral cryptorchidism. Methods: From September 2016 to August 2018, from 60 patients surgically treated for cryptorchidism, 45 children were enrolled in this single-center prospective study. Depending on the degree of testicular volume reduction, patients were divided into Group 1 with <20% reduction and Group 2 with reduction ⩾20%. Patients underwent unilateral orchidopexy and simultaneous biopsy of the undescended testis. Tanner stage was assigned. Tubular Fertility Index was measured. Results: Group 1 included 20 patients (44.4%) and Group 2 included 25 patients (55.5%). Mean age was 2.10 years (range 12 months–3.8 years) in Group 1 and 2.8 years (range 18 months–4.41 years) in Group 2. Although there is a positive correlation between testicular volume and Tubular Fertility Index, no significant association was found between groups ( p-value = 0.29). Furthermore, histological patterns did not differ significantly among groups. Conclusions: The degree of volume reduction in undescended testis does not seem to correlate significantly with the severity of histological changes that accompany cryptorchidism. Tubular Fertility Index could serve as objective tool for the assessment of future fertility.

Clinical aspects of histological and hormonal parameters in boys with cryptorchidism

“…By assessment of the fertility potential at orchidopexy with testicular histology and reproductive hormones (inhibin B, FSH, LH, and testosterone), the clinicians can achieve data on testicular state and function that can help to determine the risk of later infertility and clarify the need for supplementary treatment. Besides our group, others support the concept that testicular biopsies can serve as a prognostic tool for the fertility potential [50,200,201,202,203,205,238,239]. Supplement of hormonal assessment may reveal if there is a testicular dysfunction by impaired inhibin B to the dysgenesis verified by histology, and if the abnormal testis is compensated by elevated FSH and LH exploring the function of the hypothalamic–pituitary–gonadal axis [197].…”

“…In conclusion, the acceptance rate toward a new experimental treatment procedure among parents of Danish boys with bilateral cryptorchidism was high since 90% (95% CI 0.77-0.97) of the parents accepted. HILDORF concept that testicular biopsies can serve as a prognostic tool for the fertility potential [50,200,201,202,203,205,238,239]. Supplement of hormonal assessment may reveal if there is a testicular dysfunction by impaired inhibin B to the dysgenesis verified by histology, and if the abnormal testis is compensated by elevated FSH and LH exploring the function of the hypothalamic-pituitary-gonadal axis [197].…”