Objectives: To compare testosterone and gonadotropins characteristics of cryptorchidism in male adults before and after orchidopexy. Subjects and methods: In a follow-up study on 112 adult patients, who were operatived by orchidopexy.
: Bilateral: Compare pre- and post-orchidopexy testosteron and gonadotropin Pre orchidopexy n = 36 Post orchidopexy n = 36 p LH (IU/L) 11.6 ± 6.0 8,4 ± 3.6 < 0.001 FSH (IU/L) 22.0 ± 13.7 15.6 ± 9.8 < 0.001 Testosterone (mmol/L) 14.5 ± 7.3 16.2 ± 5.8 < 0.001 Average Post orchidopexy of bilateral group - average LH, FSH reduce Average testosterone increases (p < 0.001) Although post-operative, average FSH reduces, this hormone is still higher than the nomal value 197 Journal of military pharmaco-medicine no4-2018 DISCUSSION One year after orchidopexy, by redoing blood test to check the change of testosterone and gonadotropins of all the patients, we realize the difference about hormone levels between unilateral group and bilateral group The improvement of hormons is not similar in two groups The average LH, FSH in bilateral group are higher than unilateral one (LH: 8.4 ± 3.6 IU/L and 5.8 ± 2.0 IU/L, p < 0.001; FSH: 15.6 ± 9.8 IU/L and 7.2 ± 5.3 IU/L, p < 0.001) And the difference in testosterone level in two groups is not statistically significant despite bilateral group’s testosteron (table 1) This result is compatable with Lee P.A’s study showing that average LH, FSH in bilateral group were higher than unilateral one (FSH: 17.4 IU/L and 4.0 IU/L, p < 0.001), (LH: 7.1 IU/L and 4.6 IU/L, p = 0.023) There is no difference in average testosteron level when comparing two groups [3] Thus, after orchidopexy in male adults, the recovery of bilateral’s function is less than unilateral’s It means that the function of bilateral declines more seriously than unilateral’s if the patients are treated late in adult age [8] In unilateral group (table 2), although LH, FSH levels are in normal limit preoperation, they trend to reduce clearly post-operation appropriating for increment of testosterone The difference between pre- and post-operative showed an improvement in testical endocrine function as well as response of pituitary gland’s gonadotropins 198 In bilateral group (table 3), there was also an improvement in testosterone and gonadotropin after surgery However, average FSH level was higher than normal limit It demonstrates a severe harm of seminiferous tubules of male adults who are treated late by orchidopexy And the recovery of testical function in bilateral group is more difficult than unilateral’s Chiba’s research also showed an improvement in hormone in postoperative bilateral Average FSH level was lower (23.2 ± 5.6 vs 31.9 ± 11.6 mIU/mL, p = 0.085) Avarage LH level also was lower (6.8 ± 1.7 vs 10.9 ± 3.6 mIU/mL, p < 0.05), while testosterone level was higher (3.8 ± 2.5 vs 3.5 ± 1.9 ng/ml, p = 0.834) [1, 7] Our research’s result is somewhat contradictory with Virnadi BS’s one in 57 male adults who were treated by orchidopexy in childhood for undescend tests (47 unilateral 10 bilateral) His study showed that all the patients had nomal LH, FSH, testosterone [9] According to many authors, the difference depends on the time point of treatment and pre-or post-pubertal age CONCLUSIONS In male adults with cryptorchidism, orchidopexy helps patients to improve testical endocrine function However, the improvement is different between two groups: bilateral (post orchidolexy testosterone 16.2 ± 5.8 and preorchidolexy testosterone 14.5 ± 7.3) and unilateral (post-orchidolexy testosterone 18.8 ± 4.9 and pre-orchidolexy testosterone 17.0 ± 5.9) The improvement in pituitary’ Journal of military pharmaco-medicine no4-2018 hormone level was clearer in bilateral group (LH 11.6 ± 6.0 and 8.4 ± 3.6; FSH 22.0 ± 13.7 and 15.6 ± 9.8) Comparing with male adult group, who have orchidopexy history in childhood, the improvement of testosterone and gonadotropin is not good REFERENCES Chiba et al The efficacy of adult orchidopexy as a treatment of male infertility: Our experience of 20 cases Fertility and Sterility 2009, Vol 92, pp.1337-1339 Kurpisz M et al Cryptorchidism and long-term consequences Reproductive Biology 2010, 10 (1), pp.19-35 Lee P.A, Coughlin M.T Fertility after bilateral cryptorchidism: evaluation by paternity, hormone and semen data Hormone Research 2001, Vol 55, pp.28-32 Lenzi A et al Unilateral cryptorchidism corrected in prepubertal age: evaluation of sperm parameters, hormones, and antisperm antibodies in adult age Fertinity and Sterility 1997, 67 (5), pp.943-948 Miller K.D et al Fertility after unilateral cryptorchidism: Paternity, time to conception, pretreatment testicular location and size, hormone and sperm parameters Hormone Research 2001, Vol 55, pp.249-225 O’Shaughnessy P.J Endocrinology of the mammalian fetal testis Society for Reproduction and Fertility 2011, Vol 141, pp.37-46 Sakellaris G Cryptorchidism Essentials in Pediatric Urology 2012, pp.27-38 Scott L.S Unilateral cryptorchidism: Subsequent effects on fertility J reprod Fertil 1961, Vol 2, pp.54-60 10 Vinardi B.S et al Testicular function in men treated in childhood for undescend test Journal of Pediatric Surgery 2001, 36 (2), pp.385-388 11 Virtanen H.E et al Cryptorchidism: classification, prevalence and long-term consequences Acta Pediatrica 2007, Vol 96, pp.611-616 199 ... depends on the time point of treatment and pre-or post- pubertal age CONCLUSIONS In male adults with cryptorchidism, orchidopexy helps patients to improve testical endocrine function However,... groups: bilateral (post orchidolexy testosterone 16.2 ± 5.8 and preorchidolexy testosterone 14.5 ± 7.3) and unilateral (post- orchidolexy testosterone 18.8 ± 4.9 and pre-orchidolexy testosterone 17.0... trend to reduce clearly post- operation appropriating for increment of testosterone The difference between pre- and post- operative showed an improvement in testical endocrine function as well as