Abstract
Purpose The factors affecting spermatogenesis in adulthood in patients with hypospadias (HS) are not clearly understood. In the present study, risk factors affecting post-pubertal high serum follicle-stimulating hormone (FSH) were evaluated in patients with HS.Materials and methodsAmong those with a history of HS surgery, patients in whom endocrinological evaluation regarding pituitary–gonadal axis was performed at 15 years of age or older between March 2004 and April 2018 were enrolled in the present study. High serum FSH was defined as greater than 10 mIU/ml. The severity of HS was divided into mild and severe. Factors affecting the post-pubertal high serum FSH were estimated.ResultsSeventy-nine patients were included in the present study. The severity of HS was mild in 35 and severe in 44. History of undescended testis (UDT) was confirmed in 12. High serum FSH was detected in nine. On logistic regression model analysis, a history of UDT was the only significant factor for high serum FSH. The incidence of high serum FSH in patients with UDT was significantly higher than that in those without UDT (58.3% vs 7.5%, p < 0.01). When stratified by severity of HS and the presence of UDT, high serum FSH was detected in 70% in patients with severe HS and UDT, whereas less than 10% in other groups.ConclusionsA history of UDT was a significant factor for post-pubertal high serum FSH in patients with HS. Accordingly, the presence of UDT may be a marker for impaired spermatogenesis in patients with HS, especially in severe cases.
Highlights
Hypospadias (HS) is one of the most common congenital anomalies in male children, occurring in 0.52–8.2 of every 1000 live births [1, 2]
Given the difficulty in obtaining semen samples from asymptomatic patients, serum follicle-stimulating hormone (FSH) was used as a surrogate marker of spermatogenic function because previous studies demonstrated that FSH level in
The present study demonstrated that concomitant undescended testis (UDT) was the only risk factor for high serum FSH in patients with HS in the post-pubertal period
Summary
Hypospadias (HS) is one of the most common congenital anomalies in male children, occurring in 0.52–8.2 of every 1000 live births [1, 2]. A multifactorial etiology, including genetic, endocrine, and environmental factors, is considered to be involved in the genesis of this anomaly [3]. As male urethral development is androgen-dependent, there may be a risk of gonadal. We investigated the risk factors affecting reproductive function in patients with HS. Given the difficulty in obtaining semen samples from asymptomatic patients, serum follicle-stimulating hormone (FSH) was used as a surrogate marker of spermatogenic function because previous studies demonstrated that FSH level in. World Journal of Urology (2019) 37:2795–2799 adults seems to be correlated with spermatogenetic activity [14, 15] and to be a predictive marker for the sperm retrieval rate in patients with non-obstructive azoospermia [16, 17], exact role of FSH remains unclear
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