title: Boys with undescended testes: endocrine, volumetric and morphometric studies on testicular function before and after orchidopexy at nine months or three years of age.
abstract: BACKGROUND
  A randomized controlled study was conducted comparing the outcome of surgery for congenital cryptorchidism at 9 months or 3 yr of age.
  
  
  OBJECTIVE
  The aim of the study was to investigate whether surgery at 9 months is more beneficial than at 3 yr and to identify early endocrine markers of importance for testicular development.
  
  
  METHODS
  A total of 213 biopsies were taken at orchidopexy, and the number of germ and Sertoli cells per 100 seminiferous cord cross-sections and the surface area of seminiferous tubules and interstitial tissue were analyzed. Inhibin B, FSH, LH, and testosterone were determined. Testicular volume was assessed by ultrasonography and by a ruler.
  
  
  RESULTS
  The number of germ and Sertoli cells and testicular volume at 9 months were significantly larger than at 3 yr. The intraabdominal testes showed the largest germ cell depletion at 3 yr. At both ages, testicular volume correlated to the number of germ and Sertoli cells. None of the hormones measured during the first 6 months of life (LH, FSH, testosterone, and inhibin B) could predict the number of germ or Sertoli cells at either 9 or 36 months of age, nor could hormone levels predict whether spontaneous descent would occur or not.
  
  
  CONCLUSIONS
  Morphometric and volumetric data show that orchidopexy at 9 months is more beneficial for testicular development than an operation at 3 yr of age. Testicular volume was furthermore shown to reflect germ cell numbers in early childhood, whereas endocrine parameters could not predict cellular structure of the testis or its spontaneous descent.
authors.affiliation: Department of Women's and Children's Health, Pediatric Surgery Unit, Karolinska Institutet and University Hospital, Q2:08, SE-17176 Stockholm, Sweden. claude.kollin@karolinska.se
authors.forename: C
authors.initials: C
authors.lastname: Kollin
authors.forename: J B
authors.initials: JB
authors.lastname: Stukenborg
authors.forename: M
authors.initials: M
authors.lastname: Nurmio
authors.forename: E
authors.initials: E
authors.lastname: Sundqvist
authors.forename: T
authors.initials: T
authors.lastname: Gustafsson
authors.forename: O
authors.initials: O
authors.lastname: Söder
authors.forename: J
authors.initials: J
authors.lastname: Toppari
authors.forename: A
authors.initials: A
authors.lastname: Nordenskjöld
authors.forename: E M
authors.initials: EM
authors.lastname: Ritzén
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D003456:Cryptorchidism / Q000378:metabolism* / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000378:metabolism; D006728:Hormones / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007265:Inhibins / Q000097:blood / Q000378:metabolism; D007986:Luteinizing Hormone / Q000097:blood / Q000378:metabolism; D008297:Male; D056126:Orchiopexy / Q000379:methods / Q000534:rehabilitation; D009929:Organ Size; D013091:Spermatogenesis / Q000502:physiology; D013737:Testis / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D013739:Testosterone / Q000097:blood / Q000378:metabolism
chemical_list: D006728:Hormones; C422364:inhibin B; D013739:Testosterone; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone