Orchiopexy improves testicular temperature in children with cryptorchidism: Study
Japan: Orchiopexy is effective in improving high testis temperature caused by cryptorchidism, according to a recent study in the Journal of Urology. Also, the study found transinguinal approach to be more effective in reducing the temperature in laparoscopic Fowler–Stephens orchiopexy than an approach that created a new pathway for testicular descent medial to the inferior epigastric vessels.
Low testicular temperature is needed to maintain optimal function of germ cells; however, there is limited information regarding testicular temperature in infants and the effect of cryptorchidism and its correction, including laparoscopic staged Fowler-Stephens orchiopexy (LSFSO). To fill the knowledge gap, Koji Shiraishi, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan, and colleagues assessed the impact of orchiopexy on testicular temperature before and 12 months after surgery.
The researchers included 24 of 82 children with cryptorchidism undergoing laparoscopic Fowler–Stephens orchiopexy. They performed ultrasonographic determination of testicular volume and measurement of testicular temperature but not scrotal surface temperature using a Coretemp CTM204 before and 12 months after orchiopexy. The effects of the route of testicular delivery, conventionally through a new hiatus medial to the inferior epigastric vessels or through the transinguinal approach, were investigated in the LSFSO cases.
Key findings of the study include:
· Undescended testicular volume was significantly increased after orchiopexy (0.80 ml to 0.92 ml).
· The preoperative testicular temperature (35.1C) was significantly higher than that of the control (34.4C), and significant decreases in testicular temperature occurred after orchiopexy (34.3C).
· A multivariate analysis showed that a decrease in testicular temperature was a factor associated with postoperative testicular development.
· Twelve months after LSFSO, transinguinal approach was shown to be more effective in decreasing the testicular temperature than the conventional approach (34.4 and 35.3C, respectively).
"Our findings showed that olrchiopexy is effective in correcting the high-temperature environment caused by cryptorchidism," wrote the authors. "In the case of nonpalpable testes treated by LSFSO, transinguinal fixation is more effective than the conventional approach in reducing testicular temperature, but a longer follow-up period is necessary to draw a final conclusion."
The study titled, "Testicular Temperature and the Effects of Orchiopexy in Infants With Cryptorchidism," is published in the Journal of Urology.