The Timing of Surgery in Unilateral Inguinal Cryptorchidism: In the Aspect of Histomorphological Changes

Park, Eun; Lee, Sang Don; Choi, Kyung Woon

Abstract

PURPOSE: We prospectively evaluated whether the adequate age of surgery in patients with unilateral inguinal cryptorchidism is 1-2 years old.
MATERIALS AND METHODS
Twenty-eight specimens were taken from ipsilateral undescended testicles in 28 unilateral inguinal cryptorchid boys(age range: 4-132 months, mean: 20.3 months). Patients were divided into 2 groups: an early group I of 9 cases(7-12 months) and a late group II of 19 cases(13-132 months). Control testicular biopsies were performed in 6 hydrocele boys(age range: 8-36 months, mean: 23 months). The histomorphological changes, including spermatogonia per tubule(S/T) value, Sertoli cell index(SCI), tubular degeneration phase V-VII(TDP V-VII), mean tubular diameter(MTD), and changes of peritubular interstitial tissue(thickened tubular basement membrane and peritubular fibrosis) were compared between the cryptorchidism and control groups and the adequate age of surgery in the cryptorchid child was evaluated.
RESULTS
Testis volume, SCI, TDP V-VII, MTD, and changes of peritubular interstitial tissue, except S/T value, were significantly different between groups I and II(p<0.05). Between group I and the control group, there was a statistically significant difference in testis volume, MTD, and changes of peritubular interstitial tissue(p<0.05).
CONCLUSIONS
These findings of decreased testis volume, SCI, MTD and increased peritubular fibrosis may suggest that the appropriate timing of surgery in the cryptorchid child is under 1 year.