Morphologic effects of unilateral cryptorchidism on the contralateral descended testis

Erythropoietin Effect on Testicular Germinal Epithelium Cells in Undescended Testis Mice Model

Background:

Undescended testis is an absence of testis in the scrotum, the incidence was 15 cases per 1000 from 1974 to 1996 in Europe. At Saiful Anwar Regional Hospital East Java, from January 2015 to July 2019 there were 60 boys diagnosed with undescended testis. A temperature rise of testis located in the abdominal triggers production of reactive oxygen species, causing impairment of the testicular epithelial germ cells and spermatogenesis, leading to many complications. Erythropoietin is a glycoprotein hormone that circulates in the body and has a positive effect on ischemic injury/gonadal reperfusion.

Objective:

To find out ROS involvement in undescended testis and efficacy of EPO as an additional therapy for undescended testis.

Methods:

This study is an experimental study with a post-test only control group design, using 18 male Wistar mice conditioned to be undescended testis for 7 days and underwent orchidopexy and some are given additional erythropoietin 1000iu/Kg 3 times a week.

Results:

Before and after the intervention, the mean body weight of mice did not experience a significant difference, meanwhile testicular volume showed a significant difference between the orchidopexy and EPO groups (p = 0.005 and 0.001). Johnsen’s score were found significant in the EPO group. Malone dialdehyde level in EPO and orchidopexy group showed significant difference p = 0.01 and 0.009 when compared to undescended testis group.

Conclusion:

There was the involvement of ROS in undescended testis and additional EPO improve impairment of germinal epithelial cells and spermatogenesis process due to undescended testis.

A metastasized hepatocellular carcinoma in the capsule of an undescended testis in the right inguinal area: report of a rare case

Background

Hepatocellular Carcinoma (HCC) is the most common primary carcinoma of the liver, which mainly metastasizes through the portal vein system.

Case presentation

Here, we report an extremely rare case in which HCC metastasized to the capsule of an undescended testis in the right inguinal area of the patient. A tumor approximately 8.8 × 7.0 cm in size was found in the patient’s liver during a health check-up. Initially, it was considered a metastatic tumor because the patient was found to have cryptorchidism, which had been left untreated before he presented to our hospital. The patient underwent a radical orchiectomy via inguinal approach, and the resected testis in the right inguinal region was examined via microscopy. The cancer cells were arranged in nests and showed abundant red or clear cytoplasm and marked nuclear atypia. Immunohistochemical staining showed that the tumor cells were positive for CK, CK8/18, AFP, hepatocyte, GCP3, but negative for PLAP, CD10, CD30, CD34, and vimentin.

Conclusion

According to these findings, the tumor in the inguinal region was considered a metastatic HCC arising from the liver, rather than a seminoma that had originated in the undescended testis. We suggest that during the diagnosis of malignancies, metastatic tumors should always be considered in the differential diagnosis even if the original presentation is at rare metastatic sites or concurrent with other disease(s).

The influence of hormonal treatment with beta-human chorionic gonadotropin for cryptorchidism on future fertility in rats

INTRODUCTION

There have been two treatment modalities for cryptorchidism such that surgical and hormonal; the latter being highly controversial. While some authors suggest that hormonal treatment increases the number and maturation of germ cells in cryptorchid testes, others believe just the opposite.

OBJECTIVE

We aimed to find out the sperm counts and testicular index; briefly fertility potential of the normally descended contralateral testes in adulthood period in rats treated with Beta-HCG in early period of their lives.

MATERIALS AND METHODS

Three groups, each including 10 rats aged 22 days old, in which delactation and normal feeding can be started, were formed to be Group 1: Sham operated, Group 2: Experimental cryptorchidism (EC) and Group 3: Hormone-treated after experimental cryptorchidism was performed (HT-EC). Left testis was placed in the abdomen in group 2 and 3. In group 1, a sham operation was performed. The rats in EC-HT group received subcutaneous injections of 50 IU/kg Beta-HCG daily for 7 days. Right orchidectomy was performed when they reached reproductive period to evaluate fertility potential with sperm counts and testicular index. Testicular index was calculated according to the formula "testicular length × width/weight of rat". Epididymal sperm count was made with hemocytometer.

DISCUSSION

We evaluated the physical characteristics and fertility potential (sperm counts) of contralateral normal testes during adulthood in rats that underwent experimental unilateral cryptorchidism during infancy. A relationship between testis weight and sperm counts were also investigated. We could not find any direct correlation of sperm count with either testicular weight or testicular index in our study. Although the rats had normal testes at birth, we found decreased sperm counts in contralateral normal testes in EC group. This suggests that unilateral cryptorchidism may cause some systemic effects that reach the other testis. Hormone treatment was not beneficial. This is comparable to Nambirajan et al. who reported histological changes and decreased spermatogenic cell count in contralateral scrotal testes in experimentally induced unilateral cryptorchidism in early period of life in rats. Heiskanen et al. reported that treatment with Beta-HCG leads to decreased total sperm counts in the future due to increased germ cell apoptosis caused by hormonal withdrawal after treatment. Cortes et al. also reported decreased number of germ cells in 1-3 year-old boys who underwent surgery after unsuccessful Beta-HCG treatment. The reasons could be delayed testicular descent or adverse effect of hormone treatment though. Our results concurred with them. Apparently, our model has failed to mimic the pathophysiologic mechanisms of congenital cryptorchidism in humans. Furthermore, we applied hormone treatment in normal rats with normally descended testes. Therefore, the "by-product" information of our study is that, unnecessary use of Beta-HCG during infancy may impair future fertility.

CONCLUSION

Our study suggests that Beta-HCG treatment may decrease sperm counts and decrease the future fertility potential. We could not find any direct correlation of sperm count with either testicular weight or testicular index.

A diagnostic model for histologic damage in undescended testes based on testis rigidity measurement: an experimental study with a novel device

BACKGROUND

We aimed to test whether testis rigidity (hardness) measured using a newly-designed device we previously introduced would offer more reliable assessment of histologic damage in undescended testes than conventional methods (consistency feel at palpation, volume measurement).

MATERIALS AND METHODS

Forty-five 18-d-old Lewis rats underwent surgical inhibition of descent of left testes and were followed to 40 (n = 16), 63 (n = 14), or 90 days (n = 15). Another 45 18-d-old Lewis rats were sham operated (left side) and followed likewise (n = 14, n = 15, and n = 16). At the designated time points, testes were exposed bilaterally, rigidity was measured, and consistency at palpation was scored; testes were removed and subjected to length, width, weight measurements, volume calculation, and histomorphometry (mean Johnsen score [MJS], mean tubular diameter [MTD], and mean capsule width [MCW]). Testes of experimental group were compared with ipsilateral testes of sham-operated rats.

RESULTS

At all time points, undescended testes had decreased rigidity, MJS, and MTD, increased MCW, decreased volume and weight; contralateral testes remained unaffected. Rigidity was associated only with MJS and MTD, and most strongly with MJS (multiple stepwise linear regression, F = 694.44, P < 0.0005). MJS could be precisely predicted from rigidity: MJS = 0.699 × testis rigidity (F = 1358.82, P < 0.0005). This model showed good fit between predicted and actual MJS values (R(2) = 0.94), low error, nonsignificant bias, sensitivity 75% and specificity 90%. Model validation showed low prediction error and nonsignificant bias, indicating generalizability. Testis volume and palpation proved imprecise MJS predictors.

CONCLUSIONS

Testis rigidity is an effective predictor of histologic damage in rat undescended testes, with diagnostic value superior to testis palpation scoring and volume measurement.

Effects of compression/stretching of the spermatic cord and blunt dissection on testicular growth and fertility

PURPOSE

This study was performed to investigate whether compression/stretching of the spermatic cord or blunt dissection influences testicular development and fertility. In addition, the authors evaluated whether the extents of testicular damage differ between these 2 surgical manipulations.

METHODS

Forty-four prepubertal male Sprague-Dawley (SD) rats (Harlan Sprague-Dawley Inc, Indianapolis, Ind) were divided into 3 groups: (1) the control group (CG) animals underwent a sham operation in the right groin, (2) the experimental group 1 (EG1) underwent compression/stretching of the right spermatic cord, and (3) the experimental group 2 (EG2) underwent dissection around the right spermatic cord structures. Testicular volumes, weights, mean seminiferous tubular diameters (MSTDs), mean testicular biopsy scores, and numbers of offspring and of pregnant females were evaluated.

RESULTS

Right (operative) and left (nonoperative) testicular volumes were smaller in the EG2 group than in the CG or EG1 groups. Left MSTDs in the EG1 and EG2 groups increased more than in the CG group. Numbers of Sertoli cells in left testes differed in the 3 groups, in the order EG1 < CG < EG2. Mean testicular biopsy scores, offspring numbers, and pregnant female numbers were no different in the 3 groups.

CONCLUSIONS

Both surgical manipulations influenced testicular growth, but they did not compromise spermatogenesis or fertility in SD rats.

Cryptorchidism: incidence and sperm quality in infertile men

In a population of 8500 men attending the andrology outpatient clinic, 200 men (2.35%) were recorded as having some disturbances with the descent of the testes into the scrotum. Medical history of the patients revealed that 51 underwent unilateral orchidopexy; 40 bilateral orchidopexy; and 24 were treated with human chorionic gonadotropin in order to induce descent of their testes. In addition, 6 patients reported spontaneous descent of the testes, and 13 others were found to be unilaterally cryptorchid upon physical examination. Results of semen analysis, hormonal profile, testes position, and testicular volume were compared to those of 105 proven fertile men. The major finding of this study shows that post-partum undescended testes suffer from primary Sertoli cell malfunction as reflected by elevated serum follicle stimulating hormone levels. Serum luteinizing hormone and testosterone levels were within the normal range. Surgical descent of the testes did not improve sperm production, proved by low sperm quality of all the study groups, compared to the cryptorchid group. Among the patients who were operated on, no correlation was found between age at operation and semen variables. All groups showed poor sperm quality which can be defined as oligoteratoasthenozoospermia. The degree of spermatogenic damage was in the following order of diagnosis or treatment: bilateral orchidopexy greater than cryptorchid testes greater than hormonal treatment greater than unilateral orchidopexy greater than late spontaneous descent of the testes. Thus, it is advisable to postpone surgical treatment of cryptorchidism and apply this only after a waiting period, and if the hormonal approach has failed to descend the testis.

Testicular morphological damage in young rats after inguinotomy with vascular trauma

BACKGROUND/PURPOSE

Operations for the treatment of inguinal diseases are the most frequent in childhood. Bleeding owing to trauma to the spermatic vessels is frequent and can cause testicular atrophy. The goal of this work was to determine the effects of the trauma to the spermatic vessels in the prepubertal and postpubertal histopathologic alterations in an experimental model in Wistar rats.

METHODS

Eighty albino Wistar rats were divided in 4 groups for the histopathologic analysis. In group A, they were submitted to digital compression of the spermatic vessels for 45 seconds; in group B, the spermatic vessels were clamped with hemostats for 5 seconds; in group C, the spermatic vessels were cauterized for 2 seconds. Group D was the control group, in which the animals were submitted to inguinotomy solely.

RESULTS

The prepubertal histopathologic alterations were significantly decreased in group A for testicular weight (0.97 +/- 0.10); in group B, for testicular weight (0.81 +/- 0.24), testicular volume (0.522 +/- 0.192), and mean testicular biopsy score (7.2 +/- 2.7); and in group C, for the 5 parameters studied, testicular weight (0.69 +/- 0.28), testicular weight per 100 g of body weight (0.498 +/- 0.188), testicular volume (0.765 +/- 0.308), mean seminiferous tubular diameter (236.6 +/- 62.5), and mean testicular biopsy score (6.9 +/- 3.1). The postpubertal histopathologic alterations were not significant for any of the 5 parameters studied, in the 3 groups.

CONCLUSIONS

The prepubertal histopathologic alterations were more intense in the group submitted to cauterization of the spermatic vessels, intermediate in the group submitted to clamping of the spermatic vessels with hemostats, and less severe in the rats submitted to digital compression of the spermatic vessels. The postpubertal histopathologic alterations demonstrated the capability of the young testicle to recuperate from a vascular trauma.

Effects of hormonal treatment on the contralateral descended testis in unilateral cryptorchidism

OBJECTIVE

One of the therapeutic options in the treatment of cryptorchidism is hormonal therapy with luteinizing hormone releasing hormone (LHRH) and/or human chorionic gonadotropin (HCG); concerns have, however, been raised regarding its safety. The purpose of this study was to demonstrate that hormonal therapy improves the abnormal histology of the contralateral descended testis without harming the germ cells.

METHOD

Patients with unilateral cryptorchidism were randomized into two groups: those treated with orchiopexy alone and those treated with LHRH long acting analog and HCG. Biopsies taken from contralateral descended testes were analyzed and compared with controls.

RESULTS

The number of germ cells per tubule in contralateral testes of patients treated with orchiopexy alone is significantly lower than the number of germ cells in testes of patients with spontaneously descended testes (P<0.0001). Hormonal therapy did not have any adverse effect upon the histology of the contralateral testis, but in fact improved it. Seven weeks of hormonal therapy induced a rise in the number of germ cells per tubule (P<0.05). It was also beneficial for the number of adult dark spermatogonia per tubule and the number of primary spermatocytes, although these differences did not reach statistical significance.

CONCLUSION

The contralateral testis in patients with unilateral cryptorchidism is abnormal. Hormonal therapy improves the histopathology of the contralateral testis without harming the germ cells.

Effects of prenatal flutamide on testicular development, androgen production and fertility in rats

INTRODUCTION

To investigate the effects of blocking prenatal androgen with the anti-androgen flutamide on testicular weight (TW), seminiferous tubular diameter (STD), testicular biopsy score (TBS), testicular testosterone (TT), and fertility.

MATERIALS AND METHODS

Ten pregnant Wistar albino rats were injected with flutamide (100 mg/kg) on gestational days 16 and 19. Rats injected with the solvent were used as controls. Male pups from these dams were evaluated for testicular descent on postnatal day 22. The ability of each male to produce offspring was tested when the animals were aged 130 days. The rats were killed when 180 days old, and the testes were removed.

RESULTS

Sixteen of the 24 male rats (66.6%) exhibited cryptorchidism (6 unilateral, 10 bilateral) in the flutamide-treated group. Three of the rats with normally descended testicles were fertile, but none of the cryptorchid rats was fertile in flutamide-treated group. The average TW, mean STD, TBS and TT levels of the flutamide-treated rats was significantly lower than in the solvent-injected rats. However, there was no significant difference in these values between descended and undescended testes in flutamide-treated rats.

CONCLUSION

Blocking of prenatal androgen with flutamide interferes with testicular development by inhibiting testicular descent, and also effects testicular morphology and function in both the descended and undescended testes of rats.

The effects of human chorionic gonadotrophin on normal testicular tissue of rats: dose-dependence and reversibility

OBJECTIVE To investigate the effect of human chorionic gonadotrophin (hCG) on rat testicular tissue, and its reversibility and dose dependence. MATERIALS AND METHODS Male Wistar rats were assigned to groups (10 rats/group) receiving 10, 30 or 50 IU/kg hCG subcutaneously once daily for 15 days; 10 controls received subcutaneous isotonic saline. At 1 and 3 months later, five rats in each group were killed and their testes removed. The testes were examined histologically to measure seminiferous tubular diameter and germinal membrane thickness. RESULTS At 1 month after hCG administration, the mean germinal membrane thickness in the testicular tissues of the hCG-treated rats was significantly less than in control rats, and was also significantly different between all of the hCG-treated groups (P < 0.05). However, at 3 months after hCG administration, all histological variables were similar to those in control rats (P > 0.05), and the mean germinal membrane thickness at 3 months after hCG administration was larger than that at 1 month (P < 0.05). There were no significant differences in the mean seminiferous tubular diameter between hCG-treated rats and control rats. CONCLUSION hCG impairs seminiferous tubule histology in the 'normal' descended testes of rats. This effect was dose-dependent, and the changes were reversed at 3 months after treatment. Thus, although hCG therapy might affect the seminiferous tubules of contralateral descended testes in cryptorchid boys, these effects might be reversible.

Human Chorionic Gonadotropin Deteriorates the Histology of Rat Testes

OBJECTIVES

It is not yet certain whether early hormonal treatment in cryptorchidism is safe for germ cells. We investigated the histologic effects of human chorionic gonadotropin (hCG) therapy on descended testes of rats.

DESIGN AND SETTING

Thirty male Wistar albino rats were randomized into two groups. The rats of the hCG group (n=15) were administered 50 IU/kg/day hCG once daily via the subcutaneous route for 15 days. Fifteen rats received subcutaneous isotonic saline and acted as controls. At the first month, testicular tissue was obtained after scarification in both groups. The histological examination was performed to evaluate the seminiferous tubular diameter, germinal membrane thickness, and the percentage of the open seminiferous tubule lumen in each testis to compare the two groups.

RESULTS

The percentage of the open seminiferous tubular lumen in testicular tissues of hCG-treated rats was higher than that of controls (p<0.05). The mean germinal membrane thickness in testicular tissues of the hCG group was statistically lower than that of the control group (p<0.05). There was no statistical difference between mean seminiferous tubular diameter in testicular tissues of hCG-treated rats and controls, as expected (p>0.05). Additionally, there were two interesting cases of Sertoli cell only appearance in the hCG group.

CONCLUSIONS

We may assume that hCG impairs the seminiferous tubule histology in normal testes of rats. Thus, further experimental studies on dose dependency and the reversibility of these effects are warranted.

Testicular biopsy during orchidopexy procedure: does it have an adverse effect on fertility?

INTRODUCTION

The aim of this study is to evaluate the effect of the gonadal biopsy procedure on fertility and histology of the experimentally created undescended testis.

MATERIALS AND METHODS

Thirty Wistar-Albino rat litters were divided into three groups. In the first two groups, undescended testes were obtained by dividing the right gubernaculum in the first 48 h and the third group constituted the sham group. When the rats were 30 days old, orchidopexy was performed in the first group (O), whereas orchidopexy and testicular biopsy were performed in the second group (OB). After the fertility study all rats were sacrificed at week 11 and testicular weights, mean seminiferous tubular diameters (MSTD) and mean testicular biopsy scores (MTBS) were measured.

RESULTS

One testis in the O group and three testes in the OB group were atrophied and these rats were excluded from the study. Testicular weights, MSTD and MTBS values of the operated side in the O and OB groups were lower than those in the sham group. There was a statistically significant difference between the MSTD values of the ipsilateral testes in the OB group and sham group (p<0.05). MTBS values of the ipsilateral testes in the O and OB groups were <8. There was no difference in all parameters in the contralateral testes between all groups (p>0.05). All the evaluated rats were fertile. While there was no difference in number of fetuses and fertility scores between the O and OB group, however, the differences were significant between each of these groups and the sham group (p<0.05).

CONCLUSION

Testicular biopsy in the unilateral undescended testis model results in limited histological changes without affecting the fertility.

Apoptosis and proliferation in human undescended testes

OBJECTIVE

To study apoptosis and proliferation in the testes of children with undescended testes; the degree to which undescended testes contributes to a patient's ultimate fertility is debatable, but undescended testes have fewer germ cells, and some have proposed that apoptosis is an important cause.

PATIENTS AND METHODS

Testis biopsies were taken at the time of orchidopexy in a consecutive series of children undergoing surgical repair for undescended testes. Immunohistological techniques were used to detect apoptosis and proliferation, and the numbers of cells undergoing apoptosis or proliferation per 50 seminiferous tubules were recorded.

RESULTS

Inguinal testes had less apoptosis than abdominal testes, with a mean (sd) of 0.71 (1.31) vs 1.63 (1.95) apoptotic cells per 50 seminiferous tubules (P < 0.02). Similarly, there was less apoptosis in children aged > 1 years than in children aged < 1 years (0.68 (1.40) vs 1.35 (1.56); P < 0.03). Proliferation was very limited in all cryptorchid testes. In contrast to cryptorchid testes, five autopsy controls had many more apoptotic cells, (10.60 (1.34) per 50 seminiferous tubules), and many more proliferating cells, (8.40 (6.43) per 50 seminiferous tubules).

CONCLUSION

In contrast to animal studies, neither apoptosis nor proliferation was common in undescended testes from 6 months of age onward. However, apoptosis was more common in abdominal testes and in children aged < 1 year. It is likely that, if substantial apoptosis occurs in human undescended testes, it occurs before 6 months of age.

Testicular damage after surgical groin exploration for elective herniorrhaphy

BACKGROUND/PURPOSE

Controversy exists whether to explore the contralateral groin in boys during unilateral herniorrhaphy. Proponents claim there is minimal risk of injury to the cord structures and developing testicle with contralateral exploration. However, findings have shown testicular atrophy occurred in 1% to 2% of patients after herniorrhaphy, and vasal damage is possible after routine manipulation of the spermatic cord. This study investigated the effect of routine surgical exploration of the prepubertal groin on testicular development and future fertility.

METHODS

Twenty-four prepubertal Wistar rats were divided equally into 2 groups. Group 1 (sham) rats underwent unilateral inguinoscrotal incision only. Group 2 (experimental) rats underwent unilateral inguinoscrotal exploration with manipulation of the cord structures as in human inguinal exploration. At maturation, the fertility and fecundity of the males were assessed. After mating, testes were examined for mass, volume, mean seminiferous tubule diameter (MSTD), and mean testicular biopsy score (MTBS). The vasa were examined for histological injury and vasal diameter. Statistical comparisons were made by paired t test and Mann-Whitney rank sum test.

RESULTS

There was a difference between the volumes of the testes when comparing the operative and nonoperative side of the 2 groups (experimental, deltavol = -0.063+/-0.123; sham, deltavol = +0.067+/-0.137; P = .029). There also was a trend toward a smaller testicular mass when comparing the two sides (experimental, deltamass = -0.045+/-0.101; sham, Amass = +0.048+/-0.123; P = .057) but did not reach significance. The MSTD and MTBS were similar between the ipsilateral and contralateral testes in both groups. Likewise, the MSTD and MTBS were similar when comparing the 2 groups. All male rats in both groups were fertile. The number of offspring produced and the number of female rats impregnated were similar between the 2 groups. There was no histological evidence of vasal injury in any of the experimental spermatic cords. The vasal diameters were similar between the 2 groups.

CONCLUSION

Surgical manipulation of the prepubertal spermatic cord imparts a small, but statistically significant morphological change in testicular size without a deleterious effect on testicular development, fertility, or fecundity.

Fertility and histological studies of the contralateral testes in two different intra- and extra-abdominal rat models of unilateral cryptorchidism

OBJECTIVE

To investigate the effect of location of the testis on both testicular development and fertility in unilateral cryptorchidism.

MATERIAL AND METHODS

Forty-nine Wistar King A newborn male rats were divided into three groups. In group 1 (15 rats) intra-abdominal unilateral cryptorchidism were created by the intra-abdominal fixation of the testis in the neonatal period. In group 2 (16 rats) extra-abdominal unilateral cryptorchidism was created by extra-abdominal fixation of the gubernaculum in the neonatal period. In group 3, 18 rats underwent a sham operation as controls. At 90 days of age, fertility was then assessed in each rat by housing it with two mature virgin females for 2 weeks. Thereafter, at 115-120 days of age, the rats were killed and their testes removed for histological examination.

RESULTS

There was no significant difference in the pregnancy rate between females coupled with rats from any group, but the mean number of offspring was significantly lower in females coupled with rats in group 1 than in group 2. Furthermore, histological examination of both the cryptorchid and contralateral scrotal testes showed more severe changes in the intra-abdominal than the extra-abdominal testes.

CONCLUSION

These results suggest that intra-abdominal cryptorchid testes are significantly more impaired than extra-abdominal cryptorchid testes, and that such impairment might be caused by exposure of the testis to a higher temperature. The more severely impaired undescended testes may thus induce the degeneration of the contralateral scrotal testis and thereby cause subfertility in the intra-abdominal unilateral cryptorchid rat model.

Fertility and histological studies in a unilateral cryptorchid rat model during early and late adulthood

OBJECTIVE

To investigate the effect of age on fertility and testicular development in rats with untreated unilateral undescended testes.

MATERIALS AND METHODS

Newborn male Wistar King-A rats were divided into two groups. In group 1, a mechanical model of unilateral undescended testis was created by performing extra-abdominal fixation of the gubernaculum in the neonatal period, and in group 2, sham-operated rats were used as controls. At 90 days old (early adulthood), the fertility of both groups was assessed by mating the rats with mature virgin females for 2 weeks. Thereafter, some of the rats were killed and their testes examined histologically, while the remaining rats were allowed to develop further. At the age of 180 days (late adulthood), fertility was re-assessed in the same way. All the rats were then killed and their testes removed for histological examination.

RESULTS

There was no significant difference in pregnancy rate of females mated with males from either group in early adulthood. However, in late adulthood there was a significant reduction in pregnancy rate in females coupled with cryptorchid rats compared with that of females coupled with control rats. There was a significant degeneration of the unilateral cryptorchid testes compared with control testes in both early and late adulthood. In contrast, there were no significant changes in histological development between the contralateral scrotal testes and the controls in early adulthood, although they were significantly different from the controls in late adulthood.

CONCLUSION

These results suggest that fertility is affected by ageing in untreated unilateral cryptorchidism; this may be induced by extensive damage not only in the undescended testes, but also in the contralateral scrotal testis, in this mechanically induced model of unilateral cryptorchidism.

Técnica para produção de criptorquia experimental em ratos

Foram utilizados 18 ratos machos albinos Wistar, divididos em dois grupos de acordo com a idade e a época do sacrifício. Todos foram submetidos ao fechamento do ânulo inguinal superficial esquerdo para a produção de criptorquia experimental. Os animais de ambos os grupos sobreviveram ao procedimento e foram sacrificados no 30º. e no 60º. dias de pós-operatório. Todos apresentavam o testículo esquerdo retido.

Avaliação dos efeitos da ciclofosfamida nos testículos escrotal e retido em ratos jovens submetidos à criptorquia unilateral

Foi produzida criptorquia unilateral experimental em ratos pré-puberais. Tanto no testículo retido quanto no contralateral escrotal, foram encontradas alterações similares às observadas cm seres humanos. Essas alterações correspondem a um desenvolvimento testicular prejudicado, com degeneração da gônada. A administração crônica da droga imunossupressora ciclofosfamida, em doses baixas, evitou a deterioração do testículo tópico, a despeito de sua reconhecida ação deletéria para a espermatogênese. Tendo em vista que as lesões observadas atingem também o testículo escrotal e podem ser prevenidas pela ciclofosfamida, e discutida a possibilidade de que sejam causadas por reação auto-imune.

Fertility and unilateral undescended testis in the rat model

Fertility potential in patients with unilateral (UL) undescended testis is a debated topic. An experimental study was done in rats by surgically creating a UL undescended testis and studying its effect on their potential to father offspring when housed with female rats. No difference in fertility potential was observed in the various groups in this study. Since fertility was tested immediately after the rats became mature, it could be possible that fertility might decrease if the rats were tested in later adulthood. We conclude that experimentally created UL undescended testis does not cause damage sufficient to result in infertility in young adult rats. Also discussed is the significance of this finding in relation to UL undescended testis in humans.

Neovascularization of the testicle through spermatic vessels by omental pedicle flap: a new experimental model

The aim of this experimental study in rats was to consider the supplementary role of an omental pedicle flap on the neovascularization of the testicle through the spermatic vessels, for which a Fowler-Stephens procedure had been planned. To compare results, 12 animals had only the spermatic vessels ligated, without an additional procedure (Fowler-Stephens procedure [FS group]), and 12 others had omentopexy of the spermatic vessels of the left testes, with ligation of the vessels 4 weeks later (Fowler-Stephens procedure plus omentopexy [FSO group]). In the sham group (n = 8), only omentopexy of the left spermatic vessels was performed. Six rats served as controls. In each rat, both testes were evaluated by color Doppler ultrasonography to assess capsular and intratesticular blood flow, followed by orchiectomy to determine testicular weights, testicular biopsy scores, and mean seminiferous tubule diameters. Data were analyzed statistically. According to the color Doppler ultrasonography, the testicular blood flow in the FSO group was better than that of the FS group, but was less sufficient than that of the sham and control groups. The testicular weights and biopsy scores for the FSO group were statistically greater than those of the FS group, and less than those of the sham and control groups. There was no significant difference in the mean seminiferous tubule diameters of the FSO and FS groups. The contralateral tests of the four groups did not differ significantly for any parameter. In light of the data available, it is suggested that the omental pedicle flap neovascularizes the testicle through spermatic vessels. Given the high incidence of testicular atrophy associated with Fowler-Stephens orchiopexies, it might be beneficial to perform laparoscopic orchiopexy of testicles neovascularized with omental pedicle flaps as the first-stage procedure.

The effect of the excision of future scrotal skin on testicular descent in neonatal rats: a new experimental model of cryptorchidism

The ingunoscrotal skin of neonatal rats was widely excised on either the right or left side to examine the role of the scrotum in testicular descent. At the age of 10 days, gubernacular migration was observed to be significantly inhibited on the operated side in comparison with that on the nonoperated side. At the age of 60 to 90 days, 12 of 17 testes on the operated side were located in the superficial inguinal position, 2 were in the perineum, and another 3 had descended into the contralateral nonoperated scrotum. All the testes descended into the scrotum on the nonoperated side and in the normal control rats. Though the histological development was remarkably inhibited in the cryptorchid testis, the contralateral descended testis did show the same histological appearance as that of the control testes in 90-day-old rats. This new model of cryptorchidism is considered to provide a simple technique for investigating the mechanism of testicular descent and the impaired development of the testes in cryptorchidism.

Is ipsilateral testis mandatory for contralateral testicular deterioration encountered following spermatic cord torsion?

Although deteriorating effects of unilateral spermatic cord torsion are generally accepted, the mechanism remains controversial. An experimental study was performed to evaluate the necessity of testicular and spermatogenetic material for contralateral testicular deterioration following unilateral spermatic cord torsion in rats. The animals were allocated to four groups: control, spermatic cord torsion, subepididymal orchiectomy, and spermatic cord torsion 14 days after subepididymal orchiectomy. The testes were removed on the 14th days and mean seminiferous tubular diameters and mean testicular biopsy scores were determined. Although contralateral testicular deterioration was more pronounced in the presence of testicular tissue, the absence of testicular tissue and/or spermatogenetic material did not prevent its occurrence. This is highly suggestive that autoimmune mechanism does not play a role in contralateral testicular damage following unilateral spermatic cord torsion.

Division of the genitofemoral nerve in unilateral cryptorchid rats

The long-term effect of dividing the genitofemoral nerve supply to the undescended testis in naturally cryptorchid rats is reported. 20 male Buffalo rats with an undescended right testis, noted at the age of 30 days, were used for the investigation. 20 healthy animals served as controls. The abdominal division of the right genitofemoral nerve was performed in 10 cryptorchid and 10 healthy animals at the age of 40 days. The animals were mated at 150 days of age. Both testes were removed at 180 days of age. In each excised testis the testicular weight and seminiferous tubular diameters were measured, and the maturity of the germinal epithelium was determined using the Johnsen testiscular biopsy score. The experiment showed that in 70% of the nonoperated cryptorchid rats, both testes were affected at the age of 180 days, and 90% of these animals were infertile. In the operated cryptorchid rats, the contralateral descended were not damaged, and 60% of these animals were fertile. The division of the genitofemoral nerve in healthy animals had no effect. The results suggest that neural transmissions might play a role in the damage to the descended testis in unilateral cryptorchidism. This observation requires further investigations.

Fertility after cryptorchidism: a comparative analysis of early orchidopexy with and without concomitant hormonal therapy in the young male rat

Infertility is common in patients with a history of bilateral cryptorchidism, even after successful prepubertal orchidopexy. Recent data suggest that this defect may be partially due to the existence of hormonal abnormalities in some forms of cryptorchidism. To analyze any potential benefit of hormonal therapy, we have evaluated the immediate and long-term effects of chronic hormonal therapy administered following surgical correction of cryptorchidism. First, using young male rats, we examined the effects of chronic human chorionic gonadotropin (HCG) and a luteinizing hormone-releasing hormone agonist (LHRH-A), alone or combined, on acute pituitary-gonadal axis responsiveness to LHRH administration. High doses of HCG and/or LHRH-A induced deleterious effects on the pituitary-testicular axis in terms of suppression of response to LHRH. Therefore, treatment with a low dose of HCG (50 U/kg/day) for 14 days was used, since it produced a significant increase in intratesticular testosterone (ITT). Second, we tested this hormonal regimen in a cryptorchid rat model. Bilateral cryptorchidism was produced by gubernaculum resection at 14 days of age. Early orchidopexy was performed at age 30 days, and HCG therapy was given from 31 to 44 days of age. Follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) levels were determined before and immediately after hormonal therapy, and at sacrifice. Animals were sacrificed at 61 days of age for determination of serum and testicular hormone levels, accessory sex organ weights and testis histology. Five or six animals from each group were retained for breeding studies at the age of 90 days. Hormonal alterations noted immediately following treatment of cryptorchid animals with HCG are not lasting. The data reveal that the fertility defect in bilateral cryptorchidism is partially prevented by early orchidopexy and that adjunctive hormonal therapy is probably of little additional benefit.

The natural course of cryptorchidism in rats and the efficacy of orchidopexy or orchidectomy in its treatment before and after puberty

Both clinical and experimental evidence suggest that fertility is impaired in unilateral cryptorchidism. To investigate the effect of the undescended testis on the contralateral descended gonad, a new experimental model based on natural cryptorchidism in rats was designed. Seventy male Buffalo rats with an undescended right testis noted at the age of 30 days were used. Fifty healthy animals served as a controls. The natural course of cryptorchidism was investigated at the ages of 30, 90, and 180 days. The effects of orchiopexy and orchiectomy performed in cryptorchid animals before and after puberty were evaluated at the age of 180 days. Both nonoperated and operated animals were mated at the age of 150 days in order to estimate their fertility. The animals were killed at 30, 90, and 180 days of life and the testes were removed. In each excised testis testicular weight and seminiferous tubular diameters were measured and the maturity of the germinal epithelium was determined using the Johnsen testicular biopsy score. The experiment demonstrated reduced testicular weight and seminiferous tubular diameters in undescended testis already at 30 days and arrest of spermatogenesis at the spermatocytes stage at 90 and 180 days. There was no significant difference between contralateral descended testes and controls at the age of 30 and 90 days, but at 180 days the degenerative changes were identical with those in the cryptorchid testes. Cryptorchid rats were completely infertile. Both orchiopexy and orchiectomy prevented the damage to the contralateral testis. A significant improvement in size and spermatogenesis was recorded in most cases of the surgically descended testes.(ABSTRACT TRUNCATED AT 250 WORDS)

Subsequent testicular histology: fertility and fecundity of rats subjected to unilateral incarcerated inguinal hernia during the prepubertal period

An experimental study was designed to evaluate subsequent ipsilateral and contralateral testicular histologies, fertility, and fecundity of rats subjected to unilateral incarcerated inguinal hernia during the prepubertal period. Three study groups each containing 12 rats (28-day-old) were established. In group 1 the rats were only anesthetized. In group 2 the rats had undergone a sham operation. Left-sided incarcerated inguinal hernias were created in rats constituting group 3. After the rats had reached 4 months of age, each male rat was housed with two known fertile female rats for 3 weeks. Male rats were then castrated and the testes were evaluated histologically. Female rats were followed for 30 additional days, and the number of females impregnanted and the number of rats given birth to by each female rat were recorded. Left-sided incarcerated inguinal hernia has caused a lessened testicular/body weight ratio in the left testes, and histological deteriorations in both left and right testes that were expressed through diminished mean seminiferous tubular diameter and mean testicular biopsy scores. The fertility rate was not affected, but the number of rats produced by each male rat was lesser after having the incarcerated inguinal hernia. Unilateral incarcerated inguinal hernia during prepubertal period resulted in deteriorated ipsilateral and contralateral testicular histology and diminished the exocrine function of testes in rats.

Effects of spermatic vascular division for correction of the high undescended testis on testicular function

Orchiopexy with division of the spermatic artery and veins is a commonly used technique for correcting the high undescended testis, although the longterm results have not been clearly defined. The left spermatic artery and veins of 22 adult Wistar albino rats were divided while preserving the vessels associated with the vas and cremaster muscle (DT). A sham operation was performed on the left testicle of six additional rats (ST). At 3 weeks postoperatively, both testes from all rats were removed. All testes were viable and bled when incised, although bleeding was considerably reduced in testes with DT. Mean testicular weights after DT were 1,061 +/- 423 mg compared with 1,634 +/- 125 mg for ST rats (p less than 0.02) and 1,508 +/- 119 mg for contralateral testes. The mean tubular diameter after DT was 220 +/- 37 mu compared with 303.1 +/- 10.7 mu for ST testes (p less than 0.02). The testicular biopsy score based upon the morphology of the spermatic tubules was 4.46 +/- 3.32 for DT testes and 8.65 +/- 0.23 for ST testes (p less than 0.02) compared with 8.38 +/- 0.18 for contralateral testes and an absolute normal value of 10. No morphologic abnormalities were observed in the contralateral unoperated testes from any of the rats. The contralateral testes in 12 additional rats were removed before DT. The mean testosterone values in these rats with one testicle was 1.43 +/- 0.75 ng/mL. Three weeks after DT, testosterone values were 0.19 +/- 0.31 ng/mL (p less than 0.01). It is concluded that division of the main spermatic artery and vein in rats produces testicular atrophy with spermatogenic arrest and interstitial cell dysfunction. Although collateral blood flow to the testis may be demonstrated, tissue perfusion is inadequate for normal spermatogenesis and endocrine function.

Fertility in experimental unilateral cryptorchidism

Unilateral cryptorchidism was induced in Wistar rat pups within 48 hours of birth. Evaluation of fertility was subsequently assessed at 50, 100, and 150 days of age by paternity and daily sperm production. The descended scrotal testis was demonstrated to have a significantly diminished rate of sperm production at 150 days. Paternity studies failed to reflect this dysfunction, cryptorchid and sham-operated control animals having a 58% and 80% ability to produce offspring (P = .44).

The blood-testis barrier in experimental unilateral cryptorchidism

Unilateral cryptorchidism was induced in Wistar rat pups within 48 h of birth. After a period of 150 days, the blood-testis barrier was evaluated in the cryptorchid and contralateral scrotal testis, using a lanthanum immersion technique. The barrier was demonstrated to be competent, with tracer confined to the basal and intermediate compartments.

The fate of testes following unilateral incarcerated inguinal hernia in adult rats

The histological effects of unilateral incarcerated inguinal hernia on the ipsilateral and contralateral testes were examined in adult rats. Three groups were established. In the first group the left testis and caecum were exposed and replaced. In group 2 a left-sided incarcerated inguinal hernia was created with bilateral orchiectomy 24 h later. In group 3 a left-sided incarcerated inguinal hernia was created with reduction after 24 h. The testes of animals in groups 1 and 3 were removed after 15 days. The mean seminiferous tubular diameter (MSTD) and mean testicular biopsy score (MTBS) were determined for ipsilateral and contralateral testes in each of the 3 groups. A decreased MSTD and depressed MTBS, were pronounced in the ipsilateral testes, were found in the testes of group 3 animals. While unilateral incarcerated inguinal hernias caused more pronounced histological changes in the ipsilateral testes, they also affected the contralateral testes, but a time interval was required for the changes to become manifest.