Spermatogenesis and Cryptorchidism

Abstract

Cryptorchidism represents the most common endocrine disease in boys, with infertility more frequently observed in bilateral forms. It is also known that undescended testes, if untreated, lead to an increased risk of testicular tumors, usually seminomas, arising from mutant germ cells. In normal testes, germ cell development is an active process starting in the first months of life when the neonatal gonocytes transform into adult dark (AD) spermatogonia. These cells are now thought to be the stem cells useful to support spermatogenesis. Several researches suggest that AD spermatogonia form between 3 and 9 months of age. Not all the neonatal gonocytes transform into AD spermatogonia; indeed, the residual gonocytes undergo involution by apoptosis. In the undescended testes, these transformations are inhibited leading to a deficient pool of stem cells for post pubertal spermatogenesis. Early surgical intervention in infancy may allow the normal development of stem cells for spermatogenesis. Moreover, it is very interesting to note that intra-tubular carcinoma in situ in the second and third decades have enzymatic markers similar to neonatal gonocytes suggesting that these cells fail transformation into AD spermatogonia and likely generate testicular cancer (TC) in cryptorchid men. Orchidopexy between 6 and 12 months of age is recommended to maximize the future fertility potential and decrease the TC risk in adulthood.

Laparoscopic Orchiopexy Versus Open Orchiopexy for Palpable Undescended Testis in Children: A Prospective Comparison Study

“…U ndescended testis is one of the most common congenital abnormalities in male children, with an incidence rate of 1%. 1,2 The universally accepted and recommended treatment is orchiopexy. In the past decades, open inguinal orchiopexy has been the routine procedure for palpable undescended testis, and laparoscopic orchiopexy for nonpalpable testis.…”

Cytology of germ cells in the scrotal testes of naturally unilate­ral cryptorchid West African dwarf goats

“…Deleterious effects of cryptorchidism have been demonstrated in all cell stages of spermatogenesis (Goel et al, 2015). Previous studies reported retention of gonocytes and defective transformation of dark spermatogonia to primary spermatocyte, defective onset of meiosis (Hadziselimovic et al, 2007;Cobellis et al, 2014), germ cell degeneration in both retained and scrotal testes (Liu, 2012), congenital spermatogenic arrest (Sengupta, 2012) and reduction in fertility of the contralateral descended testis (Chung, 2011;Goel et al, 2015). However, other authors postulated that the contralateral scrotal testes are normal providing normal number of germ cells, normal distribution of dark and pale spermatogonia and primary spermatocytes (Hadziselimovic, 2008;Okpe & Ezeasor, 2016).…”

Palpable Undescended Testes: 15 Years of Experience and Outcome in Laparoscopic Orchiopexy

“…[6][7][8] It has been associated with infertility, increased risk of malignancy, testicular torsion, traumatic injury against adjacent structures, associated inguinal hernia, and psychological stigma of an empty scrotum. UDT can be categorized as congenital or acquired, and it can be defined in different ways, depending of the position of the testes: Canalicular, prepubic, prescrotal, superficial to the inguinal pouch, ectopic, and abdominal.…”

“…UDT can be categorized as congenital or acquired, and it can be defined in different ways, depending of the position of the testes: Canalicular, prepubic, prescrotal, superficial to the inguinal pouch, ectopic, and abdominal. 8,9 Besides all these possibilities, the UDT can be palpable (80%) and nonpalpable (20%). 8,10,11 At present, the gold standard for managing palpable UDT is open orchiopexy.…”

“…8,9 Besides all these possibilities, the UDT can be palpable (80%) and nonpalpable (20%). 8,10,11 At present, the gold standard for managing palpable UDT is open orchiopexy. The disadvantage of this procedure is the space limitation to achieve a wide and proper dissection of the spermatic vessels and vas deferens, which is the most important step in moving the testicle into the scrotal sac.…”