Surgical treatment of unilaterally undescended testes: testicular growth after randomization to orchiopexy at age 9 months or 3 years.
OBJECTIVE
We compared the growth of congenital, unilaterally undescended testes following orchiopexy at age 9 months or 3 years.


METHODS
Patients were randomized to surgery at age 9 months (72) or 3 years (83). Testicular volume was measured by ultrasonography at ages 6, 12, 24, 39 and 48 months.


RESULTS
Orchiopexy at age 9 months resulted in an increase in testicular volume at subsequent measurements at ages 2, 3 and 4 years compared to the volume at 6 months (p <0.001). In contrast, no significant growth was noted in the group treated at age 3 years. The improved testicular growth after early orchiopexy was also demonstrated by a gradual increase in the ratio of the previously retained testis and the scrotal testis in individual boys from 6 months to 4 years (0.68 to 0.81, p <0.001). For the late treatment group a significant decrease in this ratio was noted during the same period (0.68 to 0.56, p <0.01).


CONCLUSIONS
Surgical treatment at 9 months resulted in partial catch-up of testicular growth until at least age 4 years compared to surgery at 3 years, clearly indicating that early surgery has a beneficial effect on testicular growth. Since testicular volume is an approximate indirect measure of spermatogenic activity, this gives hope that orchiopexy at this age may improve future spermatogenesis.
Kollin
Claude
C
Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden. claude.kollin@karolinska.se
Karpe
Bengt
B
Hesser
Ulf
U
Granholm
Tina
T
Ritzén
E Martin
EM
D002675:Child, Preschool; D003456:Cryptorchidism / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D007248:Infertility, Male / Q000517:prevention & control; D016014:Linear Models; D008297:Male; D013737:Testis / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography