Dear Editor,I would like to congratulate Mamsen et al.i on their extensive and scientifically valuable work.I analyzed their raw data presented in Table 1 of the original article from a different perspective and disco...Dear Editor,I would like to congratulate Mamsen et al.i on their extensive and scientifically valuable work.I analyzed their raw data presented in Table 1 of the original article from a different perspective and discovered an effect not mentioned in the article.My analysis showed that luteinizing hormone(LH)levels are significantly lower in patients at high infertility risk(HIR),whose testes lack A dark(Ad)spermatogonia and display an abnormal ratio of germ cells per crosssectional tubule(G/T).展开更多
Dear Editor,We are much obliged that Hadziselimovic1 has used our data2 to highlight the substantial proportion of boys with cryptorchidism where gonadotropin insufficiency is an important factor related to the pathog...Dear Editor,We are much obliged that Hadziselimovic1 has used our data2 to highlight the substantial proportion of boys with cryptorchidism where gonadotropin insufficiency is an important factor related to the pathogenesis.We have recently presented a study on a series of 453 consecutive boys with bilateral nonsyndromic cryptorchidism,in which we conducted hormonal evaluations and assessed germ cell numbers in testicular biopsies.3 In this series,45%of the boys were classified as having gonadotropin insufficiency.3 Identifying these patients at the time of surgery is important.A recent follow-up study of 208 boys with nonsyndromic bilateral cryptorchidism from our department showed that the boys with gonadotropin insufficiency had an impaired fertility potential after surgery compared to boys with an intact hypothalamus–pituitary–gonadal feedback mechanism.4 In a review from 2022,Hadziselimovic5 suggested that infertility in patients diagnosed with cryptorchid testes is a consequence of a hormonal deficiency rather than temperature-induced cellular damage.展开更多
Cryptorchidism is one of the most frequent causes of nonobstructive azoospermia(NOA)in adulthood.Although it is well known that spermatogenesis is more impaired in bilateral than in unilateral cryptorchidism,previous ...Cryptorchidism is one of the most frequent causes of nonobstructive azoospermia(NOA)in adulthood.Although it is well known that spermatogenesis is more impaired in bilateral than in unilateral cryptorchidism,previous studies have only described small cohorts or inhomogeneous population.Consequently,we analyzed a cohort of 225 men with only a history of cryptorchidism as sole etiopathogenetic factor for NOA,and compared testicular sperm extraction(TESE)outcomes between men with bilateral versus unilateral cryptorchidism.Our results show no difference in follicle-stimulating hormone(FSH)levels and testicular volumes between men with a history of bilateral cryptorchidism compared to unilateral cryptorchidism(median:21.3 IU I^-1 vs 19.3 IU I^-1,P=0.306;and 7.2 ml vs 7.9 ml,P=0.543,respectively).In addition,sperm retrieval rates were similar(66.2%vs 60.0%,P=0.353).Using multivariate analysis,we have found that only a low inhibin B level(above the assay's detection limit)was positively associated with successful sperm retrieval(P<0.05).Regarding intracytoplasmic sperm injection outcomes,we found that cumulative pregnancy rate and live birth rate per cycle were not statistically different between the two groups(17.4%vs 27.8%,P=0.070;and 16.1%vs 26.4%,P=0.067,respectively).Unexpectedly,there was no significant difference in hormonal profiles(FSH,luteinizing hormone[LH],testosterone,and inhibin B levels)and TESE outcomes between unilateral versus bilateral cryptorchidism.This suggests that a history of unilateral cryptorchidism could reflect a bilateral testicular impairment.Interestingly,inhibin B level might be a predictor of successful TESE.展开更多
This study aims to explore the factors influencing the success rate of the microdissection testicular sperm extraction(Micro-TESE)in patients with nonobstructive azoospermia(NOA)and cryptorchidism.Clinical data of 162...This study aims to explore the factors influencing the success rate of the microdissection testicular sperm extraction(Micro-TESE)in patients with nonobstructive azoospermia(NOA)and cryptorchidism.Clinical data of 162 patients with cryptorchidism who underwent Micro-TESE due to infertility from December 2015 to May 2020 in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively.In the univariate analysis,significant differences in the age of patient at the time of orchidopexy(median[interquartile range,IQR]:7.0[4.0–11.0]years vs 11.5[9.0–14.5]years,P<0.001),interval between orchidopexy and Micro-TESE(mean±standard deviation:17.5±5.0 years vs 14.4±4.4 years,P<0.001),severity of cryptorchidism(unilateral[62.8%]vs bilateral[31.6%],P<0.001;location of cryptorchidism,intra-abdominal[27.3%]vs inguinal[44.8%]vs suprascrotal[66.7%],P<0.001),volume of the dominant testis(median[IQR]:17.00[15.00–19.00]ml vs 14.50[11.75–16.25]ml,P<0.001),and levels of follicle-stimulating hormone(FSH;P=0.004)and testosterone(P=0.006)were observed between the successful and failed sperm extraction groups.After conducting the multivariate analysis,four of these factors,including unilateral/bilateral cryptorchidism(P<0.001),location of cryptorchidism(P=0.032),age of orchidopexy(P<0.001),and dominant testicular volume,were adopted in the clinical prediction model to evaluate preoperatively the success rate of Micro-TESE for patients with NOA and cryptorchidism.The likelihood of successful sperm retrieval by Micro-TESE in men with NOA and cryptorchidism increased in patients with mild forms of cryptorchidism.展开更多
This paper describes features of a study of different aspects of cryptorchidism in sheep in different parts of England. A total of 83 crytorchid testes (57 unilateral and 13 bilateral) were recognised in 70 animals po...This paper describes features of a study of different aspects of cryptorchidism in sheep in different parts of England. A total of 83 crytorchid testes (57 unilateral and 13 bilateral) were recognised in 70 animals post-slaughter at three abattoirs in the south west of England between June 2000-January 2004. Abdominal cryptorchids (60) were common than inguinal (23);69% percent of cases were unilateral. External examination for cryptorchidism was carried out on 5134 young male lambs carried out in 2001 at Foot and Mouth Disease disposal sites, and on farms, during the UK outbreak of the disease. A total of 29 cases of cryptorchism [0.56%] were detected;86% of cases were unilateral. In both situations the right testis was more commonly affected than the left.展开更多
Highlights●CRISPR/Cas9 RNP complex-based strategy demonstrates robustness and accuracy in generating gene-edited sheep.●Sheep horn development remains unaffected by partial RXFP2 knockout.●Partial RXFP2 knockout re...Highlights●CRISPR/Cas9 RNP complex-based strategy demonstrates robustness and accuracy in generating gene-edited sheep.●Sheep horn development remains unaffected by partial RXFP2 knockout.●Partial RXFP2 knockout results in unilateral cryptorchidism in sheep.展开更多
This study assessed the feasibility of testis tissue cryopreservation (TTC) for fertility preservation in prepubescent boys with cryptorchidism. From January 2014 to December 2022, the University Hospital of Copenhage...This study assessed the feasibility of testis tissue cryopreservation (TTC) for fertility preservation in prepubescent boys with cryptorchidism. From January 2014 to December 2022, the University Hospital of Copenhagen (Rigshospitalet, Copenhagen, Denmark) implemented TTC for 56 boys with cryptorchidism to preserve their reproductive potential. Testis tissue samples were collected during orchiopexy (32 cases) or at subsequent follow-up procedures (24 cases), necessitated by an increased risk of infertility as indicated by hormonal assessments and/or findings from initial surgical biopsies. Testis samples were procured for TTC and pathological analysis. The cohort had an average age of 1.3 (range: 0.3–3.8) years at the time of orchiopexy, with 91.1% presenting bilateral cryptorchidism. The study revealed a median germ cell count of 0.39 (range: 0–2.88) per seminiferous tubule, with germ cells detected in 98.0% of the bilateral biopsies and 100% of the unilateral, indicating a substantial potential for fertility in these immature tissues. A dark spermatogonia (Ad) was detected in 37 out of 56 patients evaluated, with a median Ad spermatogonia count of 0.027 (range: 0.002–0.158) per seminiferous tubule. A total of 30.2% of the samples lacked Ad spermatogonia, indicative of potential gonadotrophin insufficiency. The median hormone levels measured were as follows: follicle-stimulating hormone (FSH) at 0.69 (range: 0.16–2.5) U l−1, luteinizing hormone (LH) at 0.21 (range: 0.05–3.86) U l−1, and inhibin B at 126 (range: 17–300) pg ml−1. Despite early orchiopexy, 20%–25% of boys with cryptorchidism remain at risk for future infertility, substantiating the necessity of TTC as a precaution. The study highlights the need for refined predictive techniques to identify boys at higher risk of future infertility.展开更多
This study aimed to represent the recent trends in the nationwide incidence of cryptorchidism and hypospadias in Korea, and to determine whether there is evidence of spatial heterogeneity in the incidence. The inciden...This study aimed to represent the recent trends in the nationwide incidence of cryptorchidism and hypospadias in Korea, and to determine whether there is evidence of spatial heterogeneity in the incidence. The incidence was calculated as the number of newly diagnosed patients （males） during the first 4 years after a live birth in a population, nationally and regionally （a non-industrialized area （Chuncheon） and petrochemical estates （Yeocheon and Ulsan））, between 2000 and 2005. The data （numerator） for new patients were acquired from the National Health Insurance Review Agency, and the data （denominator） for the resident registration population were from the National Statistical Office. Between 2000 and 2005, the national incidence of cryptorchidism and hypospadias had an increased tendency from 5.01 to 17.43 per 10 000 persons and from 1.40 to 3.28 per 10 000 persons, respectively. The incidence of cryptorchidism was significantly higher in Yeocheon （throughout the study period） and in Ulsan （2001, 2002, 2004 and 2005） than the national incidence, whereas the incidence in Chuncheon was significantly lower in 2001 and 2002. It was difficult to compare the rates of hypospadias yearly and regionally because of the small number of cases. In conclusion, the incidence of cryptorchidism has recently increased in Korea. The petrochemical estates, Yeocheon and Ulsan, had a significantly higher incidence of cyptorchidism than the national incidence, which suggests that further study is needed to obtain a more precise estimation of the trends in the incidence of the anomalies and to confirm the association between petrochemicals and the anomalies.展开更多
Aim: To evaluate the long term effect of experimental cryptorchidism on germ cell apoptotic rate and testicular sperm content in adult rats. Methods: Bilateral cryptorchidism was created in 40 adult male Sprague-Dawle...Aim: To evaluate the long term effect of experimental cryptorchidism on germ cell apoptotic rate and testicular sperm content in adult rats. Methods: Bilateral cryptorchidism was created in 40 adult male Sprague-Dawley rats by surgically manipulating the testes into the abdominal cavity and closing the internal inguinal ring. The rats were sacrificed and the testes removed 6 hours and 2, 4, 7, 21, 28 and 56 days after cryptorchidism. Germ cell apoptosis was quantified by means of TUNEL assay and apoptosis was confirmed using transmission electron microscopy. Results: The rate of apoptosis peaked at 4 days of cryptorchidism and then progressively declined to a nadir at 14 days of cryptorchidism. At 56 days of cryptorchidism, the germinal epithelium was largely depleted by the apoptotic process and only a few mature sperm were seen within the testis. At this point, a few tubules were seen to be repopulating with primary spermatocytes and the level of germ cell apoptosis began to increase marginally. Testicular sperm count (TSC) began to decline rapidly at day 7 of cryptorchidism. Only a few mature sperm were found in the testes of rats following 56 days of cryptorchidism. Multinucleated giant cells (MGC) were most numerous within the seminiferous tubules at day 4. At day 7, 35 % of MGCs were TUNEL positive. At all subsequent time points, however, MGCs fail to stain positive for apoptosis. This resumption of increased apoptosis coincided with the appearance of a population of primary spermatocytes in some seminiferous tubules. Moreover, there was not a corresponding increase in the number of mature sperm after 56 days of cryptorchidism. Conclusion: The decline in germ cell apoptosis after 4 days of cryptorchidism can be attributed to be the result of an overall depletion of germ cells. It appears that after a prolonged cryptorchidism (56 days), there is a limited resumption of spermatogenesis presumably as a result of a decrease in the maturing germ cells undergoing programmed cell death.展开更多
Abdominal cocoon syndrome(ACS) is a rare cause of intestinal obstruction due to total or partial encapsulation of the small intestine by a fibrocollagenous membrane. Idiopathic ACS with abdominal cryptorchidism and gr...Abdominal cocoon syndrome(ACS) is a rare cause of intestinal obstruction due to total or partial encapsulation of the small intestine by a fibrocollagenous membrane. Idiopathic ACS with abdominal cryptorchidism and greater omentum hypoplasia is even rarer clinically. We successfully treated a 26-year-old male case of small bowel obstruction with acute peritonitis. He was finally diagnosed with idiopathic ACS with unilateral abdominal cryptorchidism and greater omentum hypoplasia during exploratory laparotomy. He then underwent enterolysis, cryptorchidectomy, and appendectomy. He recovered gradually from the operations and early postoperative inflammatory ileus. There has been no recurrence of intestinal obstruction since the operation, and he is still in follow-up. We analyzed his clinical data and retrospectively reviewed the literature, and our findings may be helpful for the clinical diagnosis and treatment on ACS.展开更多
Aim： To assess the spatiotemporal changes in the expression of extracellular signal-regulated kinases 1 and 2 （ERK1/ 2）, c-Jun N-terminal kinases （JNK） and p38 mitogen-activated protein kinases （MAPK） in respon...Aim： To assess the spatiotemporal changes in the expression of extracellular signal-regulated kinases 1 and 2 （ERK1/ 2）, c-Jun N-terminal kinases （JNK） and p38 mitogen-activated protein kinases （MAPK） in response to heat stress in the cryptorchid testis, and to investigate a possible relation to Sertoli cell dedifferentiation. Methods： Immunohistochemistry and western blot were used to examine the expression and activation of ERK1/2, p38 and JNK in the cryptorchid testis at various stages after experimental cryptorchidism. Results： The abdominal temperature did not obviously change the total ERK1/2 expression but significantly activated phospho-ERK1/2 in the Sertoli cells of the cryptorchid testis. Heat stress increased total JNK expression in the Sertoli cells of the cryptorchid testis but did not activate phospho-JNK. Neither total p38 nor phospho-p38 was induced by heat stress in the Sertoli cells of the cryptorchid testis. Changes in the spatiotemporal expression of cytokeratin 18 （CK18）, a marker of immature or undifferentiated Sertoli cells, were induced in the cryptorchid testis in a pattern similar to the activation of ERK1/2. Condusion： The activation of ERK1/2 in the testis may be related to dedifferentiation of Sertoli cells under heat stress induced by experimental cryptorchidism.展开更多
Autophagy is invoIved in spermatogenesis by regulating germ cell maturation.This catabolic process increases with hyperthermic conditions to prevent the accumulation of damaged organelles.Cryptorchidism is associated ...Autophagy is invoIved in spermatogenesis by regulating germ cell maturation.This catabolic process increases with hyperthermic conditions to prevent the accumulation of damaged organelles.Cryptorchidism is associated with impairment of germ cell maturation revealed by the presence of immature forms of sperm cells in ejaculates.The aim of the present study was to evaluate the status of autophagy in sperm cells from cryptorchid patients.Semen samples of cryptorchid patients and normozoospermic controls were analyzed by immuno cytochemistry and electron microscopy.Autophagy protei ns,autophagy-related protein 9(ATG9)and microtubule-associated protein,lA/lB-light chain 3(LC3)were localized by immunocytochemistry on the acrosome and on the equatorial segment of sperm cells.LC3 was also detected in the midpiece of cryptorchid sperm tail.Autophagy substrate p62 protein was present in the acrosome and in the postequatorial segment of sperm in control samples,but not in the cryptorchid ones.Transmission electron microscopy revealed double-membrane-limited autophagosomes in postequatorial part of spermatozoa head and midpiece in cryptorchid samples.Partly degraded mitochondria were frequently discerned in autophagic vacuoles.In conclusion,autophagy is increased in sperm cells from patients with cryptorchid history comparatively to control.Our work provides insights into the role of autophagy in the maturation and survival of human male gametes in pathological conditions.Thus,regulating autophagy could represent a potential way to improve sperm quality in cryptorchid men.展开更多
We describe and summarize the diagnosis,treatment,and reasons for delayed treatment of children with cryptorchidism torsion in Children's Hospital of Chongqing Medical University.The study included 19 cases of cry...We describe and summarize the diagnosis,treatment,and reasons for delayed treatment of children with cryptorchidism torsion in Children's Hospital of Chongqing Medical University.The study included 19 cases of cryptorchidism torsion.The age of the children ranged from 16 days to 12 years(median:6 years).The interval from diagnosis to surgery varied from 4 h to 16 days(median:3 days).Ultrasound was performed in all cases.Fifteen cases had cryptorchidism torsion,2 cases had a soft tissue mass in the inguinal region,and 2 cases had an inguinal/abdominal teratoma.Five cases were treated with an orchidopexy,12 cases were treated with orchiectomy,and 2 cases received resection of a testicular tumor.The 5 children with an orchidopexy were followed up from 1 month to 7 years(median:3 years),with 1 child having a testis retraction and no blood supply.Of the 12 children who had an orchiectomy,three had delayed diagnosis due to family unawareness of the condition,while other delays were due to delayed referral from primary care facilities.The relative rarity and insufficient awareness of cryptorchidism torsion resulted in a low rate of testicular salvage.Therefore,hospitals of all levels should be fully aware of cryptorchidism with torsion and ensure a male child's genital system and inguinal region are examined to improve the success rate of testicular salvage.展开更多
Cryptorchidism affects the growth of testicular volume.Testicular volume is associated with reproductive function.The testicular atrophy index evaluates the degree of damage caused by cryptorchidism,but it remains unc...Cryptorchidism affects the growth of testicular volume.Testicular volume is associated with reproductive function.The testicular atrophy index evaluates the degree of damage caused by cryptorchidism,but it remains unclear whether changes in testicular atrophy index are related to age.We selected patients who underwent surgery for unilateral palpable cryptorchidism.Testicular volume was measured using ultrasonography.The testicular atrophy indices of the undescended testes were then reviewed,and their correlation with age was analyzed.We studied 228 cases(age range:6–53 months).Scatter plots were constructed,and Loess curves were fitted,revealing a turning point at 24 months of age.The patients were divided into age groups of 6–24 months and 25–53 months.The testicular volume of the cryptorchid side was smaller than that of the normal side in both groups(both P<0.001).In the 6–24-month group,the testicular atrophy index was positively correlated with age,testicular volume on the cryptorchid side was not correlated with age,and testicular volume was positively correlated with age on the normal side.In the 25–53-month group,testicular atrophy index and testicular volumes on either side were not correlated with age.A palpable unilateral cryptorchid testis is smaller than the contralateral testis.The testicular atrophy index increases with age between 6 months and 24 months,but not between 25 months and 53 months.Testicular volume increased with age on the normal side between 6 months and 24 months,but not on the cryptorchid side.Trends in testicular atrophy index with age contribute to the decision of operation time.展开更多
Pubertal development may be altered in boys with cryptorchidism and hypospadias,but existing kno wledge is inc on siste nt.Therefore,we investigated the association between cryptorchidism and hypospadias and pubertal ...Pubertal development may be altered in boys with cryptorchidism and hypospadias,but existing kno wledge is inc on siste nt.Therefore,we investigated the association between cryptorchidism and hypospadias and pubertal development in a large cohort study.Boys in the Puberty Cohort,a cohort nested within the Danish National Birth Cohort,were in eluded in this study.Information on cryptorchidism and hypospadias was retrieved from the Danish National Patient Register.From 11 years until 18 years or full pubertal developme nt,info rmatio n on physical markers of pubertal developme nt was provided biannu ally,in eluding Tanner stages,axillary hair,acne,voice break,and first ejaculation.In multivariate regression models for interval censored data,the mean(95%confidence intervals[Cis])d iff ere nces in months in obtaining the pubertal markers between boys with and without the anomalies were estimated.Among 7698 boys,196(2.5%)had cryptorchidism and 60(0.8%)had hypospadias.Boys with hypospadias experienced first ejaculation and voice break 7.7(95%Cl:2.5-13.0)months and 4.5(95%Cl:0.3-8.7)months later than boys without hypospadias?The age at attaining the Tanner stages for gonadal and pubic hair growth was also higher,though not statistically significant.Pubertal development seemed unaffected in boys with mild as well as severe cryptorchidism?In conclusion,hypospadias may be associated with delayed pubertal development,but pubertal development seems unaffected by cryptorchidism.The relation between hypospadias and later pubertal development may be due to the underlying shared in utero risk or genetic factors.展开更多
This study was performed to summarize our clinical experience with testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children.This study included 1034 chi...This study was performed to summarize our clinical experience with testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children.This study included 1034 children with palpable cryptorchidism from March 2009 to March 2019.A scrotal stria incision was used to perform testicular descent and fixation.Overall,1020 children successfully underwent surgical testicular descent and fixation through a scrotal stria incision,and 14 patients underwent conversion to inguinal incision surgery.All patients were discharged 1-2 days after the operation.During hospitalization and follow-up,55 patients developed complicationsy including 10 patients with testicular retraction,7 with poor healing of the incision,and 38 with a scrotal hematoma.No patients developed testicular atrophy,an in direct ingui nal hernia,or a hydrocoele.Testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children is safe and feasible in well-selected cases.This method has the advantages of no scarring and a good cosmetic effect.展开更多
Objective: We summarized the relationship between the descent of a testicle into the scrotum and testicular cancer.Methods: Twenty-eight patients with testicular cancer after surgical treatment of cryptorchidism were ...Objective: We summarized the relationship between the descent of a testicle into the scrotum and testicular cancer.Methods: Twenty-eight patients with testicular cancer after surgical treatment of cryptorchidism were retrospective analysis.Results: All patients were performed surgical treatment of cryptorchidism from 2 to 28 years old (median,12 years;average,16 years).Testicular cancer age ranged from 19 to 53 years (median,33 years;average,36 years).Malignant transformation occurred from 3 to 25 years of operation time (average,18 years).Twenty-seven cases of malignant cryptorchidism ipsilateral,contralateral malignancy in 1 case,27 cases were underwent radical resection of testicular cancer.Pathology diagnosis was mainly seminoma.Retroperitoneal lymph node dissection was done in 3 cases,18 cases were chemotherapy and radiotherapy in 3 cases.Conclusion: The undescended testicle is the most common genital malformation in boys.When diagnosed,it should be treated as early as possible,but successful treatment appears not to lessen the risk of testicular cancer,patients must be closely monitored follow-up.展开更多
Objective: To study the transforming growth factor β receptor Ⅱ (TGFβ-R Ⅱ) expression in experimental cryptorchidism and apoptosis in spermatogenic cells in rats. Methods: The apoptosis of spermatogenic cells was ...Objective: To study the transforming growth factor β receptor Ⅱ (TGFβ-R Ⅱ) expression in experimental cryptorchidism and apoptosis in spermatogenic cells in rats. Methods: The apoptosis of spermatogenic cells was detected by means of the terminal deoxynucleotldyl transferase mediated dUTP nick end lableling method (TUNEL) and the TGFβ-R Ⅱ expression was observed with the immunohistochemistry SABC methods. Results: There was a significant increase in the TGFβ-R Ⅱ expression in unilateral undescended testes (UUTs) compared with that in contralateral descended testes (CDTs, P<0.01). However, there was a significant and time-dependent increase in the mean apoptotic index in UUTs than in CDTs. Conclusion: TGFβ-R Ⅱ may play an important role in spermatogenic cell apoptosis.展开更多
Objective To evaluate semen quality in infertile men with a history of unilateral cryptorchidism Methods Semen samples were obtained from 47 infertile men with a history of unilateral cryptorchidism. Semen analysis an...Objective To evaluate semen quality in infertile men with a history of unilateral cryptorchidism Methods Semen samples were obtained from 47 infertile men with a history of unilateral cryptorchidism. Semen analysis and membrane integrity including both eosin Y stain and hyo-osmotic swelling tests were performed using standard procedures. All men were divided into three groups according to their age at surgery of orchidopexy as follows： group A, 2-7 years （n=23）, group B, 8-13 years （n=14） and group C, 14-17years （n=10）. Results There was wide range for sperm count and motility for all the subjects studied. Majority of men had high percentage of abnormal sperm morphology. Among the three groups of men, group A and B had significantly higher sperm count, motility and membrane integrity than that of group C. Group C also had the highest frequency of oligoasthenoteraozoospermia （50%） than group A （17%） and group B （35%）. Conclusion Semen quality of men with a history of unilateral cryptorchidism appears to be related to their age of performing orchidopexy. Surgery at early age of childhood may improve spermatogenesis which results in better semen quality in adulthood.展开更多
文摘Dear Editor,I would like to congratulate Mamsen et al.i on their extensive and scientifically valuable work.I analyzed their raw data presented in Table 1 of the original article from a different perspective and discovered an effect not mentioned in the article.My analysis showed that luteinizing hormone(LH)levels are significantly lower in patients at high infertility risk(HIR),whose testes lack A dark(Ad)spermatogonia and display an abnormal ratio of germ cells per crosssectional tubule(G/T).
文摘Dear Editor,We are much obliged that Hadziselimovic1 has used our data2 to highlight the substantial proportion of boys with cryptorchidism where gonadotropin insufficiency is an important factor related to the pathogenesis.We have recently presented a study on a series of 453 consecutive boys with bilateral nonsyndromic cryptorchidism,in which we conducted hormonal evaluations and assessed germ cell numbers in testicular biopsies.3 In this series,45%of the boys were classified as having gonadotropin insufficiency.3 Identifying these patients at the time of surgery is important.A recent follow-up study of 208 boys with nonsyndromic bilateral cryptorchidism from our department showed that the boys with gonadotropin insufficiency had an impaired fertility potential after surgery compared to boys with an intact hypothalamus–pituitary–gonadal feedback mechanism.4 In a review from 2022,Hadziselimovic5 suggested that infertility in patients diagnosed with cryptorchid testes is a consequence of a hormonal deficiency rather than temperature-induced cellular damage.
文摘Cryptorchidism is one of the most frequent causes of nonobstructive azoospermia(NOA)in adulthood.Although it is well known that spermatogenesis is more impaired in bilateral than in unilateral cryptorchidism,previous studies have only described small cohorts or inhomogeneous population.Consequently,we analyzed a cohort of 225 men with only a history of cryptorchidism as sole etiopathogenetic factor for NOA,and compared testicular sperm extraction(TESE)outcomes between men with bilateral versus unilateral cryptorchidism.Our results show no difference in follicle-stimulating hormone(FSH)levels and testicular volumes between men with a history of bilateral cryptorchidism compared to unilateral cryptorchidism(median:21.3 IU I^-1 vs 19.3 IU I^-1,P=0.306;and 7.2 ml vs 7.9 ml,P=0.543,respectively).In addition,sperm retrieval rates were similar(66.2%vs 60.0%,P=0.353).Using multivariate analysis,we have found that only a low inhibin B level(above the assay's detection limit)was positively associated with successful sperm retrieval(P<0.05).Regarding intracytoplasmic sperm injection outcomes,we found that cumulative pregnancy rate and live birth rate per cycle were not statistically different between the two groups(17.4%vs 27.8%,P=0.070;and 16.1%vs 26.4%,P=0.067,respectively).Unexpectedly,there was no significant difference in hormonal profiles(FSH,luteinizing hormone[LH],testosterone,and inhibin B levels)and TESE outcomes between unilateral versus bilateral cryptorchidism.This suggests that a history of unilateral cryptorchidism could reflect a bilateral testicular impairment.Interestingly,inhibin B level might be a predictor of successful TESE.
文摘This study aims to explore the factors influencing the success rate of the microdissection testicular sperm extraction(Micro-TESE)in patients with nonobstructive azoospermia(NOA)and cryptorchidism.Clinical data of 162 patients with cryptorchidism who underwent Micro-TESE due to infertility from December 2015 to May 2020 in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively.In the univariate analysis,significant differences in the age of patient at the time of orchidopexy(median[interquartile range,IQR]:7.0[4.0–11.0]years vs 11.5[9.0–14.5]years,P<0.001),interval between orchidopexy and Micro-TESE(mean±standard deviation:17.5±5.0 years vs 14.4±4.4 years,P<0.001),severity of cryptorchidism(unilateral[62.8%]vs bilateral[31.6%],P<0.001;location of cryptorchidism,intra-abdominal[27.3%]vs inguinal[44.8%]vs suprascrotal[66.7%],P<0.001),volume of the dominant testis(median[IQR]:17.00[15.00–19.00]ml vs 14.50[11.75–16.25]ml,P<0.001),and levels of follicle-stimulating hormone(FSH;P=0.004)and testosterone(P=0.006)were observed between the successful and failed sperm extraction groups.After conducting the multivariate analysis,four of these factors,including unilateral/bilateral cryptorchidism(P<0.001),location of cryptorchidism(P=0.032),age of orchidopexy(P<0.001),and dominant testicular volume,were adopted in the clinical prediction model to evaluate preoperatively the success rate of Micro-TESE for patients with NOA and cryptorchidism.The likelihood of successful sperm retrieval by Micro-TESE in men with NOA and cryptorchidism increased in patients with mild forms of cryptorchidism.
文摘This paper describes features of a study of different aspects of cryptorchidism in sheep in different parts of England. A total of 83 crytorchid testes (57 unilateral and 13 bilateral) were recognised in 70 animals post-slaughter at three abattoirs in the south west of England between June 2000-January 2004. Abdominal cryptorchids (60) were common than inguinal (23);69% percent of cases were unilateral. External examination for cryptorchidism was carried out on 5134 young male lambs carried out in 2001 at Foot and Mouth Disease disposal sites, and on farms, during the UK outbreak of the disease. A total of 29 cases of cryptorchism [0.56%] were detected;86% of cases were unilateral. In both situations the right testis was more commonly affected than the left.
基金supported by the National Key Research and Development Program of China(2022YFD1300200)the National Natural Science Foundation of China(32161143010,32202646,and 32272848)+2 种基金the China Agriculture Research System(CARS-39)the Key Special Project of Ningxia Science and Technology Department,China(2021BEF02024)the local grants,China(NXTS2021-001,2022GD-TSLD-46,NK2022010207,and NXTS2022-001)。
文摘Highlights●CRISPR/Cas9 RNP complex-based strategy demonstrates robustness and accuracy in generating gene-edited sheep.●Sheep horn development remains unaffected by partial RXFP2 knockout.●Partial RXFP2 knockout results in unilateral cryptorchidism in sheep.
基金financially supported by the University Hospital of Copenhagen,Rigshospitalet,the Danish Child Cancer Foundation(2021-7395)Vissing Fonden(519140 AHO/PPT)the Research Fund between Rigshospitalet and Odense University Hospital(136-A5544).
文摘This study assessed the feasibility of testis tissue cryopreservation (TTC) for fertility preservation in prepubescent boys with cryptorchidism. From January 2014 to December 2022, the University Hospital of Copenhagen (Rigshospitalet, Copenhagen, Denmark) implemented TTC for 56 boys with cryptorchidism to preserve their reproductive potential. Testis tissue samples were collected during orchiopexy (32 cases) or at subsequent follow-up procedures (24 cases), necessitated by an increased risk of infertility as indicated by hormonal assessments and/or findings from initial surgical biopsies. Testis samples were procured for TTC and pathological analysis. The cohort had an average age of 1.3 (range: 0.3–3.8) years at the time of orchiopexy, with 91.1% presenting bilateral cryptorchidism. The study revealed a median germ cell count of 0.39 (range: 0–2.88) per seminiferous tubule, with germ cells detected in 98.0% of the bilateral biopsies and 100% of the unilateral, indicating a substantial potential for fertility in these immature tissues. A dark spermatogonia (Ad) was detected in 37 out of 56 patients evaluated, with a median Ad spermatogonia count of 0.027 (range: 0.002–0.158) per seminiferous tubule. A total of 30.2% of the samples lacked Ad spermatogonia, indicative of potential gonadotrophin insufficiency. The median hormone levels measured were as follows: follicle-stimulating hormone (FSH) at 0.69 (range: 0.16–2.5) U l−1, luteinizing hormone (LH) at 0.21 (range: 0.05–3.86) U l−1, and inhibin B at 126 (range: 17–300) pg ml−1. Despite early orchiopexy, 20%–25% of boys with cryptorchidism remain at risk for future infertility, substantiating the necessity of TTC as a precaution. The study highlights the need for refined predictive techniques to identify boys at higher risk of future infertility.
文摘This study aimed to represent the recent trends in the nationwide incidence of cryptorchidism and hypospadias in Korea, and to determine whether there is evidence of spatial heterogeneity in the incidence. The incidence was calculated as the number of newly diagnosed patients （males） during the first 4 years after a live birth in a population, nationally and regionally （a non-industrialized area （Chuncheon） and petrochemical estates （Yeocheon and Ulsan））, between 2000 and 2005. The data （numerator） for new patients were acquired from the National Health Insurance Review Agency, and the data （denominator） for the resident registration population were from the National Statistical Office. Between 2000 and 2005, the national incidence of cryptorchidism and hypospadias had an increased tendency from 5.01 to 17.43 per 10 000 persons and from 1.40 to 3.28 per 10 000 persons, respectively. The incidence of cryptorchidism was significantly higher in Yeocheon （throughout the study period） and in Ulsan （2001, 2002, 2004 and 2005） than the national incidence, whereas the incidence in Chuncheon was significantly lower in 2001 and 2002. It was difficult to compare the rates of hypospadias yearly and regionally because of the small number of cases. In conclusion, the incidence of cryptorchidism has recently increased in Korea. The petrochemical estates, Yeocheon and Ulsan, had a significantly higher incidence of cyptorchidism than the national incidence, which suggests that further study is needed to obtain a more precise estimation of the trends in the incidence of the anomalies and to confirm the association between petrochemicals and the anomalies.
文摘Aim: To evaluate the long term effect of experimental cryptorchidism on germ cell apoptotic rate and testicular sperm content in adult rats. Methods: Bilateral cryptorchidism was created in 40 adult male Sprague-Dawley rats by surgically manipulating the testes into the abdominal cavity and closing the internal inguinal ring. The rats were sacrificed and the testes removed 6 hours and 2, 4, 7, 21, 28 and 56 days after cryptorchidism. Germ cell apoptosis was quantified by means of TUNEL assay and apoptosis was confirmed using transmission electron microscopy. Results: The rate of apoptosis peaked at 4 days of cryptorchidism and then progressively declined to a nadir at 14 days of cryptorchidism. At 56 days of cryptorchidism, the germinal epithelium was largely depleted by the apoptotic process and only a few mature sperm were seen within the testis. At this point, a few tubules were seen to be repopulating with primary spermatocytes and the level of germ cell apoptosis began to increase marginally. Testicular sperm count (TSC) began to decline rapidly at day 7 of cryptorchidism. Only a few mature sperm were found in the testes of rats following 56 days of cryptorchidism. Multinucleated giant cells (MGC) were most numerous within the seminiferous tubules at day 4. At day 7, 35 % of MGCs were TUNEL positive. At all subsequent time points, however, MGCs fail to stain positive for apoptosis. This resumption of increased apoptosis coincided with the appearance of a population of primary spermatocytes in some seminiferous tubules. Moreover, there was not a corresponding increase in the number of mature sperm after 56 days of cryptorchidism. Conclusion: The decline in germ cell apoptosis after 4 days of cryptorchidism can be attributed to be the result of an overall depletion of germ cells. It appears that after a prolonged cryptorchidism (56 days), there is a limited resumption of spermatogenesis presumably as a result of a decrease in the maturing germ cells undergoing programmed cell death.
基金Supported by Major Projects of Chinese PLA"13~(th) Five-Year Plan" Logistics Research Subject,No.AKJ15J003
文摘Abdominal cocoon syndrome(ACS) is a rare cause of intestinal obstruction due to total or partial encapsulation of the small intestine by a fibrocollagenous membrane. Idiopathic ACS with abdominal cryptorchidism and greater omentum hypoplasia is even rarer clinically. We successfully treated a 26-year-old male case of small bowel obstruction with acute peritonitis. He was finally diagnosed with idiopathic ACS with unilateral abdominal cryptorchidism and greater omentum hypoplasia during exploratory laparotomy. He then underwent enterolysis, cryptorchidectomy, and appendectomy. He recovered gradually from the operations and early postoperative inflammatory ileus. There has been no recurrence of intestinal obstruction since the operation, and he is still in follow-up. We analyzed his clinical data and retrospectively reviewed the literature, and our findings may be helpful for the clinical diagnosis and treatment on ACS.
基金Acknowledgment This study was supported by the National Natural Science Foundation of China （30230190）, the National Basic Science Research and Development Project （973） （G1999055901） and the Chinese Academy of Sciences （CAS） Knowledge Innovation Program （KSCX-2-SW-201）.
文摘Aim： To assess the spatiotemporal changes in the expression of extracellular signal-regulated kinases 1 and 2 （ERK1/ 2）, c-Jun N-terminal kinases （JNK） and p38 mitogen-activated protein kinases （MAPK） in response to heat stress in the cryptorchid testis, and to investigate a possible relation to Sertoli cell dedifferentiation. Methods： Immunohistochemistry and western blot were used to examine the expression and activation of ERK1/2, p38 and JNK in the cryptorchid testis at various stages after experimental cryptorchidism. Results： The abdominal temperature did not obviously change the total ERK1/2 expression but significantly activated phospho-ERK1/2 in the Sertoli cells of the cryptorchid testis. Heat stress increased total JNK expression in the Sertoli cells of the cryptorchid testis but did not activate phospho-JNK. Neither total p38 nor phospho-p38 was induced by heat stress in the Sertoli cells of the cryptorchid testis. Changes in the spatiotemporal expression of cytokeratin 18 （CK18）, a marker of immature or undifferentiated Sertoli cells, were induced in the cryptorchid testis in a pattern similar to the activation of ERK1/2. Condusion： The activation of ERK1/2 in the testis may be related to dedifferentiation of Sertoli cells under heat stress induced by experimental cryptorchidism.
文摘Autophagy is invoIved in spermatogenesis by regulating germ cell maturation.This catabolic process increases with hyperthermic conditions to prevent the accumulation of damaged organelles.Cryptorchidism is associated with impairment of germ cell maturation revealed by the presence of immature forms of sperm cells in ejaculates.The aim of the present study was to evaluate the status of autophagy in sperm cells from cryptorchid patients.Semen samples of cryptorchid patients and normozoospermic controls were analyzed by immuno cytochemistry and electron microscopy.Autophagy protei ns,autophagy-related protein 9(ATG9)and microtubule-associated protein,lA/lB-light chain 3(LC3)were localized by immunocytochemistry on the acrosome and on the equatorial segment of sperm cells.LC3 was also detected in the midpiece of cryptorchid sperm tail.Autophagy substrate p62 protein was present in the acrosome and in the postequatorial segment of sperm in control samples,but not in the cryptorchid ones.Transmission electron microscopy revealed double-membrane-limited autophagosomes in postequatorial part of spermatozoa head and midpiece in cryptorchid samples.Partly degraded mitochondria were frequently discerned in autophagic vacuoles.In conclusion,autophagy is increased in sperm cells from patients with cryptorchid history comparatively to control.Our work provides insights into the role of autophagy in the maturation and survival of human male gametes in pathological conditions.Thus,regulating autophagy could represent a potential way to improve sperm quality in cryptorchid men.
基金supported by the Basic Research and Frontier Exploration Project of Chongqing Science and Technology Bureau of Yuzhong District(No.20200151).
文摘We describe and summarize the diagnosis,treatment,and reasons for delayed treatment of children with cryptorchidism torsion in Children's Hospital of Chongqing Medical University.The study included 19 cases of cryptorchidism torsion.The age of the children ranged from 16 days to 12 years(median:6 years).The interval from diagnosis to surgery varied from 4 h to 16 days(median:3 days).Ultrasound was performed in all cases.Fifteen cases had cryptorchidism torsion,2 cases had a soft tissue mass in the inguinal region,and 2 cases had an inguinal/abdominal teratoma.Five cases were treated with an orchidopexy,12 cases were treated with orchiectomy,and 2 cases received resection of a testicular tumor.The 5 children with an orchidopexy were followed up from 1 month to 7 years(median:3 years),with 1 child having a testis retraction and no blood supply.Of the 12 children who had an orchiectomy,three had delayed diagnosis due to family unawareness of the condition,while other delays were due to delayed referral from primary care facilities.The relative rarity and insufficient awareness of cryptorchidism torsion resulted in a low rate of testicular salvage.Therefore,hospitals of all levels should be fully aware of cryptorchidism with torsion and ensure a male child's genital system and inguinal region are examined to improve the success rate of testicular salvage.
基金funded by the Medical Science and Technology Research Project of Henan Province provided by the Health Commission of Henan Province(No.LHGJ20190383).
文摘Cryptorchidism affects the growth of testicular volume.Testicular volume is associated with reproductive function.The testicular atrophy index evaluates the degree of damage caused by cryptorchidism,but it remains unclear whether changes in testicular atrophy index are related to age.We selected patients who underwent surgery for unilateral palpable cryptorchidism.Testicular volume was measured using ultrasonography.The testicular atrophy indices of the undescended testes were then reviewed,and their correlation with age was analyzed.We studied 228 cases(age range:6–53 months).Scatter plots were constructed,and Loess curves were fitted,revealing a turning point at 24 months of age.The patients were divided into age groups of 6–24 months and 25–53 months.The testicular volume of the cryptorchid side was smaller than that of the normal side in both groups(both P<0.001).In the 6–24-month group,the testicular atrophy index was positively correlated with age,testicular volume on the cryptorchid side was not correlated with age,and testicular volume was positively correlated with age on the normal side.In the 25–53-month group,testicular atrophy index and testicular volumes on either side were not correlated with age.A palpable unilateral cryptorchid testis is smaller than the contralateral testis.The testicular atrophy index increases with age between 6 months and 24 months,but not between 25 months and 53 months.Testicular volume increased with age on the normal side between 6 months and 24 months,but not on the cryptorchid side.Trends in testicular atrophy index with age contribute to the decision of operation time.
文摘Pubertal development may be altered in boys with cryptorchidism and hypospadias,but existing kno wledge is inc on siste nt.Therefore,we investigated the association between cryptorchidism and hypospadias and pubertal development in a large cohort study.Boys in the Puberty Cohort,a cohort nested within the Danish National Birth Cohort,were in eluded in this study.Information on cryptorchidism and hypospadias was retrieved from the Danish National Patient Register.From 11 years until 18 years or full pubertal developme nt,info rmatio n on physical markers of pubertal developme nt was provided biannu ally,in eluding Tanner stages,axillary hair,acne,voice break,and first ejaculation.In multivariate regression models for interval censored data,the mean(95%confidence intervals[Cis])d iff ere nces in months in obtaining the pubertal markers between boys with and without the anomalies were estimated.Among 7698 boys,196(2.5%)had cryptorchidism and 60(0.8%)had hypospadias.Boys with hypospadias experienced first ejaculation and voice break 7.7(95%Cl:2.5-13.0)months and 4.5(95%Cl:0.3-8.7)months later than boys without hypospadias?The age at attaining the Tanner stages for gonadal and pubic hair growth was also higher,though not statistically significant.Pubertal development seemed unaffected in boys with mild as well as severe cryptorchidism?In conclusion,hypospadias may be associated with delayed pubertal development,but pubertal development seems unaffected by cryptorchidism.The relation between hypospadias and later pubertal development may be due to the underlying shared in utero risk or genetic factors.
文摘This study was performed to summarize our clinical experience with testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children.This study included 1034 children with palpable cryptorchidism from March 2009 to March 2019.A scrotal stria incision was used to perform testicular descent and fixation.Overall,1020 children successfully underwent surgical testicular descent and fixation through a scrotal stria incision,and 14 patients underwent conversion to inguinal incision surgery.All patients were discharged 1-2 days after the operation.During hospitalization and follow-up,55 patients developed complicationsy including 10 patients with testicular retraction,7 with poor healing of the incision,and 38 with a scrotal hematoma.No patients developed testicular atrophy,an in direct ingui nal hernia,or a hydrocoele.Testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children is safe and feasible in well-selected cases.This method has the advantages of no scarring and a good cosmetic effect.
文摘Objective: We summarized the relationship between the descent of a testicle into the scrotum and testicular cancer.Methods: Twenty-eight patients with testicular cancer after surgical treatment of cryptorchidism were retrospective analysis.Results: All patients were performed surgical treatment of cryptorchidism from 2 to 28 years old (median,12 years;average,16 years).Testicular cancer age ranged from 19 to 53 years (median,33 years;average,36 years).Malignant transformation occurred from 3 to 25 years of operation time (average,18 years).Twenty-seven cases of malignant cryptorchidism ipsilateral,contralateral malignancy in 1 case,27 cases were underwent radical resection of testicular cancer.Pathology diagnosis was mainly seminoma.Retroperitoneal lymph node dissection was done in 3 cases,18 cases were chemotherapy and radiotherapy in 3 cases.Conclusion: The undescended testicle is the most common genital malformation in boys.When diagnosed,it should be treated as early as possible,but successful treatment appears not to lessen the risk of testicular cancer,patients must be closely monitored follow-up.
文摘Objective: To study the transforming growth factor β receptor Ⅱ (TGFβ-R Ⅱ) expression in experimental cryptorchidism and apoptosis in spermatogenic cells in rats. Methods: The apoptosis of spermatogenic cells was detected by means of the terminal deoxynucleotldyl transferase mediated dUTP nick end lableling method (TUNEL) and the TGFβ-R Ⅱ expression was observed with the immunohistochemistry SABC methods. Results: There was a significant increase in the TGFβ-R Ⅱ expression in unilateral undescended testes (UUTs) compared with that in contralateral descended testes (CDTs, P<0.01). However, there was a significant and time-dependent increase in the mean apoptotic index in UUTs than in CDTs. Conclusion: TGFβ-R Ⅱ may play an important role in spermatogenic cell apoptosis.
文摘Objective To evaluate semen quality in infertile men with a history of unilateral cryptorchidism Methods Semen samples were obtained from 47 infertile men with a history of unilateral cryptorchidism. Semen analysis and membrane integrity including both eosin Y stain and hyo-osmotic swelling tests were performed using standard procedures. All men were divided into three groups according to their age at surgery of orchidopexy as follows： group A, 2-7 years （n=23）, group B, 8-13 years （n=14） and group C, 14-17years （n=10）. Results There was wide range for sperm count and motility for all the subjects studied. Majority of men had high percentage of abnormal sperm morphology. Among the three groups of men, group A and B had significantly higher sperm count, motility and membrane integrity than that of group C. Group C also had the highest frequency of oligoasthenoteraozoospermia （50%） than group A （17%） and group B （35%）. Conclusion Semen quality of men with a history of unilateral cryptorchidism appears to be related to their age of performing orchidopexy. Surgery at early age of childhood may improve spermatogenesis which results in better semen quality in adulthood.
