Cryptorchidism: Fowler-Stephens procedure or autotransplantation—a new experimental model

Abstract

Objectives. To investigate the effect of different operative procedures on testicular development in cryptorchidism. Methods. One hundred ten postpubertal Wistar-WU rats were divided into four groups. Group 1 (35 rats) underwent microsurgical autotransplantation of the right testis with end-to-end anastomosis of the testicular vessels. Group 2 (35 rats) underwent the Fowler-Stephens maneuver with intra-abdominal fixation of the testis. To determine the influence of temperature on testicular development, group 3 (35 rats) underwent the Fowler-Stephens maneuver with scrotal replacement of the testis. Group 4 (5 rats) was a control group without operative treatment. To assess the early and late changes of testicular ischemia and reperfusion, groups 1 to 3 were divided into seven subgroups (5 rats each) with defined postoperative intervals (0.5 hour, 2 hours, 4 hours, 8 hours, 16 hours, 14 days, and 60 days). Testicular development, sperm density, pH value, tissue lactate concentration, and tubular diameter were the parameters used to determine success or failure. Results. After autotransplantation, testicular development exhibited an atrophy rate of less than 50% and a significant decrease in groups 2 and 3 after 60 days. The sperm density was significantly different between groups 2 and 4 (control). The pH value was significantly different after 2 hours in groups 2 and 3. The tissue lactate concentration revealed no significant differences. The tubular diameters were significantly diminished in group 2 after 60 days. Conclusions. The smaller atrophy rate of the testes suggests that we successfully established a model in the rat to compare the operative outcome after autotransplantation and the Fowler-Stephens procedure in cryptorchidism. The significant difference in the tubular diameters for the intra-abdominally placed testes might be caused by the exposure of the testis to a higher temperature.