Orchidopexy In Adulthood Improve Male Fertility

Main Category: Fertility
Also Included In: Urology / Nephrology
Article Date: 02 Jul 2008 - 4:00 PDT

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ORLANDO, FL (UroToday.com) - This is a report of 33 infertile men with undescended testes who underwent orchidopexy in one institution. The mean age was 31,2 years ( 24 - 35 years). UT was bilateral in 36.4 % of the cases and unilateral in 63.6 %. UT was in inguinal position in all patients with a mean size was of 15 ml. Preoperative semen analysis demonstrated severe to mild oligo-astheno-teratozoospermia (69,7 %) and azoospermia (30,3%).

Interestingly 20% 20 % of azoospermic patients demonstrated 1,6.106 spermatozoids / ml spontaneous pregnancy was achieved in 4 couples (12 %) after a mean follow-up of 13 months (7 to 22 months). The authors conclude that surgical correction of UT at adulthood can improve semen quality and increase the rate of paternity.

Editorial Comment: This abstract would seem to indicate that there is a beneficial effect of orchiopexy in the bilaterally cryptorchid adult in whom other options do not exists. As the authors note, late orchiopexy is associated with increased incidence of testicular cancer. As reported in the NEJM, the relative risk of testicular cancer among those who underwent orchiopexy before reaching 13 years of age was 2.23 and for those treated at 13 years of age or older, the relative risk was 5.40. That being said, one would hope that we will no longer be faced with this therapeutic dilemma.

(Pettersson A. Richiardi L. Nordenskjold A. Kaijser M. Akre O. Age at surgery for Undescended Testis and Risk of Testicular Cancer New England Journal of Medicine. 356(18):1835-41, 2007 May 3.)

Presented by Mohamed N Mhiri, MD, et al., at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Harris M. Nagler, MD

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