Testicular Temperature and the Effects of Orchiopexy in Infants with Cryptorchidism.

Abstract

Testicular temperature should remain low to maintain optimal function of germ cells; however, information regarding testicular temperature in infants and the effect of cryptorchidism and its correction, including laparoscopic staged Fowler-Stephens orchiopexy (LSFSO), is limited. A total of 82 infants with unilateral palpable cryptorchidism, 24 with nonpalpable testes who underwent unilateral LSFSO and 20 with scrotal hydrocele were included. Ultrasonographic determination of testicular volume and measurement of testicular temperature but not scrotal surface temperature using a Coretemp CTM204® (Terumo, Tokyo) were performed 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. Undescended testicular volume was significantly increased after orchiopexy (0.80 ml to 0.92 ml, p <0.0001). The preoperative testicular temperature (35.1C) was significantly higher than that of the control (34.4C, p <0.0001), and significant decreases in testicular temperature occurred after orchiopexy (34.3C, p <0.0001). 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, p <0.05). Orchiopexy is effective in correcting the high-temperature environment caused by cryptorchidism. 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 followup period is necessary to draw a final conclusion.