Abdominal Cryptorchidism Research Articles

Draught and draught‐related breeds are also affected by testicular teratoma: A retrospective study on cryptorchidism

SummaryBackgroundThere is limited information regarding cryptorchid teratomas other than a few case report studies, and almost all involved standard‐frame horse breeds.ObjectiveTo investigate the prevalence of testicular teratoma in horses presented for cryptorchidism and to determine its relationship with horse breeds.Study designRetrospective case series.MethodsMedical records from all horses presented for cryptorchidism that underwent surgical cryptorchidectomy between January 2010 and August 2021 in a single institution were reviewed. Additionally, cryptorchid horses with a histopathological diagnosis of testicular teratoma were further analysed.ResultsCryptorchidectomy was performed in 220 horses (253 testicles: 187 unilateral and 33 bilateral). Left abdominal cryptorchidism was the most common presentation (101/187, 54%), followed by right abdominal (37/187, 20%) and then, right (27/187, 14%) and left (22/187, 12%) inguinal. A teratoma was confirmed via histopathology in two Draughts, one Draught‐related breed (Canadian horse) and one Paint. Unfortunately, a pre‐operative diagnosis of teratoma was not reached in 3/3 horses where only routine caudal ultrasonography was performed. Draught and draught‐related breeds represented 6% (2219/36,857) of the hospital caseload during the study period and 11% (24/220) of the entire cryptorchid population. Draught and draught‐related breeds had a 37.1 relative risk ratio of having a cryptorchid teratoma (95% CI: 7.85–175.73) in this study. However, this may have been coincidental or specific to our geographic location given the small number of affected cases.Main limitationsRetrospective nature of the study, small population of horses, one institution and by extent one geographical location.ConclusionsWe found that cryptorchid teratomas are encountered with a high prevalence in our draught and draught‐related breed caseload. A thorough pre‐operative ultrasound, including cranio‐ventral abdomen, may be recommended in cryptorchids to facilitate identification of large teratomas lying cranially within the abdomen as well as surgical planning.

Spermatic cord torsion associated with perineal hernia in a cryptorchid dog

AbstractAn 8‐year‐old male German Shepherd dog with a history of dyschezia, tenesmus and perineal swelling for 1 month was referred. The dog was known to be unilaterally abdominal cryptorchid. The normally descended testis had been surgically removed a few years ago. On physical examination, a firm, non‐painful, irreducible mass was palpable in the left perineal region. Digital rectal examination revealed rectal deviation, and the pelvic diaphragm was absent on the left. The prostate gland was normal upon palpation. Abdominal radiography revealed that the urinary bladder was present in the caudal abdomen. Based on clinical, laboratory and imaging findings, a diagnosis of perineal hernia was made. Surgical exploration revealed the presence of left spermatic cord torsion in the perineal hernia. The testis was removed, and internal obturator muscle transposition was performed for herniorrhaphy. The dog had an uneventful recovery, and the results of re‐examinations 10 days, 6 months and 12 months later were normal.

Single-port laparoscopic-assisted abdominal cryptorchidectomy in 14 dogs.

To describe a modified laparoscopic-assisted cryptorchidectomy technique in dogs using a single-port endoscope and evaluate clinical outcome in abdominal cryptorchid dogs that underwent the procedure. Prospective case series. A total of 14 client-owned dogs (19 abdominal cryptorchid testes). Dogs scheduled for laparoscopic cryptorchidectomy between January 2019 and April 2022 were enrolled in the study. The dogs underwent single-port laparoscopic-assisted cryptorchidectomy (SP-LAC) performed by a single surgeon using a 10-mm single-port endoscope placed in the midline immediately cranial to the prepuce. The abdominal testis was endoscopically located and grasped, the cannula was retracted, the capnoperitoneum was reversed to allow exteriorization of the testis, and the spermatic cord was ligated extracorporeally. Median age was 13 months (range, 7-29 months) and median bodyweight was 23.0 kg (range, 2.2-55.0 kg). Nine of 14 dogs had unilateral abdominal cryptorchidism (7 right-sided and 2 left-sided) and 5/14 dogs had bilateral abdominal cryptorchidism. Median surgical time for unilateral abdominal cryptorchidectomy was 17 min (range, 14-21 min) and for bilateral abdominal cryptorchidectomy 27 min (range, 23-55 min). Ten dogs had additional surgical procedures performed concurrently with SP-LAC. One major intraoperative complication (testicular artery hemorrhage) occurred that required emergency conversion and two minor entry-related complications were observed. The SP-LAC procedure enabled removal of abdominal testes and was associated with a low morbidity. The SP-LAC procedure can be performed by a single surgeon and represents a less invasive alternative to multi-port laparoscopic-assisted or single-port multi-access laparoscopic cryptorchidectomy techniques.

Anti-Müllerian hormone levels in serum and testes of male dogs: relations with neuter status and bilateral abdominal cryptorchidism

Anti-Müllerian hormone (AMH) analysis has contributed to new information in the reproductive endocrinology of domestic animals, due to clinically available diagnostic tools. An accurate and rapid diagnostic method to distinguish between neutered and bilateral abdominal cryptorchid dogs is needed in veterinary practice. Therefore, this study uses an enzyme-linked immunosorbent assay to evaluate the clinical relevance of AMH analysis in peripheral blood as a diagnostic tool for dogs with suspected bilateral abdominal cryptorchidism. The possible alteration of the AMH localization in testicular tissue caused by this pathologic condition was also investigated using immunohistochemistry. Male dogs were divided into three groups of healthy intact (n = 14), healthy castrated (n = 14), and bilateral abdominal cryptorchid (n = 14) dogs. The results demonstrated a higher level of serum AMH in the cryptorchid group compared to the intact group (P < 0.01), while serum AMH levels of all castrated dogs were below the limit of detection (<0.05 ng/mL). Moreover, the percentage of positive AMH immunostaining of the intact group was less than that of the cryptorchid group (P < 0.01). A significantly positive correlation was found between serum AMH concentration and localization in testicular tissues (r = 0.93, P < 0.01). Our findings suggest that AMH levels in the peripheral blood could be used as an alternative and rapid screening method for detecting dogs with abdominal cryptorchidism.

Abdominal Cryptorchidism with Complete Dissociation between the Testis and Deferent Duct Mimicking Testicular Regression Syndrome

Complete separation of the deferent duct from the epididymis in cryptorchid testes residing in the abdomen is an extremely rare variant of developmental disorders of the testis and epididymis. Available sources mention only three clinical cases similar to our observations. The unique anatomic aspects of this disorder hamper the correct diagnosis of an intra-abdominal cryptorchid testis. Two boys with nonpalpable left-sided cryptorchidism underwent diagnostic laparoscopy, revealing an intra-abdominally located testis. The epididymis was completely separated from the deferent duct, and the epididymis and testis were supplied by testicular vessels. Exploration of the inguinal canal revealed blind-ending deferent ducts. The testis was brought down through the inguinal canal and fixed in the scrotum in both boys. The follow-up examination at 6 months revealed no signs of testicular atrophy or malposition of the testis in either patient. With our observations in mind, the exclusive use of a transscrotal or transinguinal approach as the initial surgical exploration in the treatment of patients with nonpalpable forms of cryptorchidism may be inappropriate. Careful laparoscopic examination of the abdominal cavity is indispensable in children with suspected testicular regression syndrome or nonpalpable forms of cryptorchidism.

BILATERAL CRYPTORCHIDISM IN PEDIATRIC SURGEON'S PRACTICE: CURRENT TACTICS OF PATIENT MANAGEMENT.

The aim: To provide best practices of disease management to improve treatment outcomes for this group of patients. Materials and methods: The paper is based on first-hand experience in observing and treating 117 children aged from 6 months to 13 years with bilateral congenital cryptorchidism during a ten-year follow-up period, who were referred for surgical treatment, and 3 newborn boys with undescended testicles and testicular torsion. A complex of clinical and laboratory, instrumental, endocrinological, and genetic research methods was used for the survey of all patients. Results: Recognizing the action of a common causative factor for bilateral cryptorchidism, which is a consequence of primary endocrine disorders, makes it possible to predict bilateral identity of the location of testicles in this pathology, which we observed in 81 patients: bilateral inguinal cryptorchidism was registered in 49 (41.88%) children, bilateral abdominal cryptorchidism - in 32 (27.35%) children, a combination of inguinal and abdominal cryptorchidism - in 24 (20.51%) children. The following types of treatment were used in the studied group of children: 1 - primary surgical intervention - 4 children, representing 3.42%. 2 - observation and non-surgical treatment by an endocrinologist - 113 (96.58%) children. 3 - comprehensive treatment (surgical correction after hormone treatment) - 67 (59.29%) children. According to the research, hormone therapy had a positive effect on descent of the testicles in 89 (78.76%) patients: the testicles descended into the scrotum - in 22 (24.72%) children; the testicles descended in the inguinal canal - in 32 (35.95%) children; the testicles descended to the level of the opening to the inguinal canal - in 35 (39.33%) children. Conclusions: 1. All doctors, starting from the maternity hospital, polyclinic, children's unit, should identify children with bilateral cryptorchidism. All children diagnosed with bilateral cryptorchidism are referred to a surgeon or endocrinologist. The parents of a child with bilateral cryptorchidism should immediately consult a doctor. The study of the reasons for late admission of children to the surgical hospital revealed that 76.92% of patients sought medical advice late, after 1 year of life. 2. At the stage of diagnosis and determination of treatment tactics, an examination by an endocrinologist and a geneticist is necessary; ignoring them is considered an error in diagnostic and therapeutic tactics, since the process of descent of the testicles into the scrotum is hormone-dependent. 3. The indications for primary surgical treatment of a child with bilateral cryptorchidism involve a combination of cryptorchidism with inguinal hernia and pain syndrome, which might be caused by testicular torsion. 4. Hormone therapy provides better results of surgical intervention in bilateral cryptorchidism. The ineffectiveness of two courses of hormone therapy necessitates surgical treatment. 5. Comprehensive treatment of children with bilateral cryptorchidism (non-surgical hormone therapy and surgical correction) has led to good postoperative results in 71.64% of patients, satisfactory results - in 22.39% of children, recurrences - in 5.97% of patients. 7. A long-term follow-up observation should be carried out by a surgeon and endocrinologist until patients reach their reproductive years.

Абдоминальный крипторхизм на фоне полной диссоциации яичка и семявыносящего протока, имитирующей синдром тестикулярной регрессии.

Introduction. Complete separation of the deferent duct from the epididymis with the testicle in abdominal cryptorchidism cases is an extremely rare variation of abnormal development of genitals in boys. Available sources mention just 3 clinical cases similar to our observations. The unique anatomic details of the abnormality and extreme rarity of its exposure pave the way for a failure to reveal an intra-abdominal testis, and determine the need for particular attention during diagnostic laparoscopy. Materials and methods. Two patients with non-palpable left-sided cryptorchidism underwent a diagnostic laparoscopy, which revealed an intra-abdominal testis with epididymis on testicular vessels that was completely separated from the deferent duct. The difference between the described clinical cases was in the distance between the deep inguinal ring and the crossing of testicular vessels from the retroperitoneal location to the intraperitoneal position, which was approximately 3- 4 cm in the first patient and 4-5 mm in the second one. The second difference was in the "closed" deep inguinal ring found on the left side in the first case while the second patient had a patent processus vaginalis case. In both cases an incision was made in the left inguinal area, the inguinal canal was opened, and exploration thereof revealed blind-ended deferent ducts. The testicle in both cases was brought down through the inguinal canal and attached in the scrotum. Results. No complications occurred during the early postoperative care period, the check-up examination in 6 months following the surgery revealed no signs of testis atrophy or malposition in both patients. Conclusion. In diagnostic laparoscopy for abdominal cryptorchidism, it is important to consider the possibility of complete separation of the testicle and vas deferens. Detection of the deferent duct passing through the «closed» deep inguinal ring together with hypoplastic vessels does not rule out the chances for an ipsolateral intra-abdominal testis; therefore, a careful examination of the abdominal cavity along the embryological testicular migration path is necessary.

Prevalence of chronic pain after herniorrhaphy, orchiopexy, and bernardi procedure in children. A retrospective-prospective study

Chronic postsurgical pain (CPSP) is defined as pain that develops or increases in intensity after a surgical procedure and persists for at least three months. Its prevalence rate ranges from 5% to 54%. Aim - to assess the prevalence of CPSP among children at the age of 7-18 years residing in the Precarpathian region at three and six months after herniorrhaphy, orchiopexy and Bernardi procedure. Materials and methods. There were observed 92 children at the age of 7-18 years, who underwent treatment for abdominal wall hernia, cryptorchidism, varicocele, and hydrocele at the surgical department. Children were divided into the following groups: Group 1a included children at the age of 7-12 years with acute pain syndrome in the postoperative period; Group 1b comprised children at the age of 13-18 years with acute pain syndrome in the postoperative period; Group 2a included children at the age of 7-12 years with chronic pain syndrome; Group 2b included children at the age of 13-18 years with chronic pain syndrome. Results. The prevalence of CPSP following surgery among children of the Precarpathian region was found to be 33.7%, with a male predominance (р&lt;0.05). There was an increased need for postoperative pain management with paracetamol in children of Group 2a (р&lt;0.05). The mean scores of the Face, Legs, Activity, Cry, Consolability (FLACC) scale were significantly higher in children of Group 2a, 2b as compared to Group 1a, 1b (р&lt;0.05). The Visual Analogue Scale (VAS) confirmed greater pain intensity in children of Group 2a on the second and third days of treatment (р&lt;0.05). Conclusions. The high prevalence of chronic pain in children after herniorrhaphy, orchiopexy by Petrivalsky / Schoemaker technique, Ross and Bernardi procedures is due to ineffective perioperative pain management that requires the use of additional analgesia techniques, including regional ones. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Successful treatment of severely burned pediatric patient with comorbid disease burden

Combustion pathology remains one of the most topical and social important problems of practical public health. A special category of burned patients are children with numerous comorbidities. Purpose - to present the clinical case of successful management of severe burn victim – the child with numerous birth defects and comorbidities. Materials and methods. A 7-year-old male patient V. The diagnosis «Third-degree flame burn, 45% of the total body surface area in the regions of upper extremities, buttocks, lower extremities. Mummification of the feet and legs - to the middle third. Inhalation injury. Burn disease. Burn shock, grade IV. Cerebral palsy. Unbalanced chromosome pathology. Statokinetic development delay. Psychomotor development retardation. Hyperhomocysteinemia. Muscle hypotension syndrome. Acute gastritis. Congenital heart disease. Arachnoid cyst. Partial optic nerve atrophy. Concomitant convergent strabismus. Right-sided abdominal cryptorchidism. Aphthous dermatitis. Polyvalent food allergy». The patient underwent early necrectomy-amputation, three necrectomies followed by wound closure with xenoderm grafts, and four skin autografting procedures. Results. Extremely severe thermal trauma in patients with serious congenital pathology was previously thought by experts to be the injury incompatible with life. In the clinical case presented, the patient’s life was saved due to early surgical treatment, which included guillotine amputation-necrectomy of lower extremities aimed at radical debridement to prevent the development of severe burn disease, along with appropriate infusion and pharmacological therapy. Subsequent surgical procedures stabilized the patient’s condition, decreased the severity of injury, arrested the progression of burn disease, thus leading to his recovery. By the time of discharge from the hospital (on day 91 post injury), the wounds had completely healed, laboratory parameters were within normal limits. Conclusions. The prognoses like “the injury is not compatible with life, and treatment is symptomatic" should not be pronounced by clinicians in general and by burn experts in particular. To save the patient’s life by all possible means should be the primary goal for all medical professionals. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: burns, children, congenital malformations, concomitant pathology, treatment.

КЛИНИЧЕСКИЙ СЛУЧАЙ АДЕНОМЫ ЯИЧКА У ПАЦИЕНТА С ПОЛИОРХИЗМОМ

The article presents a clinical case of a 53-year-old patient admitted to the hospital with a suspected testicular tumor. Preliminary diagnosis: congenital anomaly. Adenomatoid tumor of the undescended right testicle (inguinal cryptorchidism on the right). Polyorchism. Abdominal cryptorchidism of the accessory right testicle. Irreducible indirect inguinal hernia on the right. Alpha fetoprotein, HCG, LDH indices are normal, no metastases were found. Orchofuniculectomy on the right, herniotomy, local tissue rearrangement were performed. The accessory testis was classified as Type A1 by Bergholz R.

Етапна лапароскопічна тракційна орхіопексія за Shehata: перший досвід, технічні особливості, результати

Purpose – to evaluate the results of proposed method of staged laparoscopic traction orchiopexy by Shehata on the basis of our own experience in the treatment of children with abdominal cryptorchidism. Materials and methods. During the period 2019–2021, 18 boys aged 9 months – 4 years were operated with staged laparoscopic traction orchiopexy procedure. Right unilateral abdominal cryptorchidism observed in 10 children, left – in 6, bilateral – in 2. Indications for the procedure were cases of intra-abdominal testicular retention with short vessels. Results. Pelvic and iliac retentions observed in 44% of cases. In 22% testicles were located close to the inner inguinal ring, in 33% the distance between testicle and inguinal canal opening reached 3–4 cm. The 2nd stage was carried out in 3 months. Successful orchiopexy was conducted then in 94% cases without any vascular tension. No cases of testicular dislocation or atrophy have been reported. The volume of operated testicles was smaller than the healthy ones in 78% cases objectively. Conclusions. The experience of Shehata operation showed good effect of the method for correction of abdominal cryptorchidism. Indications for staged laparoscopic traction orchiopexy are abdominal undescended testicles with insufficient length of vessels. The technique allows to achieve effective elongation of spermatic vessels in a short period of time and to minimize the risks of atrophy, compared with the 2-stage Fowler–Stephens operation. This study was conducted in accordance with the principles of the Helsinki Declaration. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed parental agreement was obtained for the research. No conflict of interests was declared by the authors. Key words: abdominal cryptorchidism, orchiopexy, staged treatment, Shehata procedure.

Repeated surgical interventions for relapses of cryptorchidism in children

The aim of the study is to demonstrate a differentiated approach to recurrent cryptorchidism treatment. Materials and methods. Over the past five years (since 2015), the staff of the Department of Pediatric Surgery of A.I. Evdokimov Moscow State University of Medicine and Dentistry, performed surgical treatment of 20 children aged 2-17 years with recurrent cryptorchidism (22 testicles). Relapse of cryptorchidism on one side was diagnosed in 18 patients. Two patients had a bilateral cryptorchidism recurrence, these children had a combined pathology in the form of Prader-Willi syndrome. In 3 children, surgical treatment at their place of residence was performed two or more times. As a preoperative preparation to increase the elasticity of blood vessels and to lengthen them, a course of human chorionic gonadotropin (hCG) hormone therapy was carried out according to the scheme. The exception was children over the age of 6-7 as administration of hCG at this age can provoke an earlier onset of puberty. Intraoperatively, in 15 children, the testicle was fixed in the scrotum according to the method of Shemaker, Herzen, and others. In 5 children with abdominal cryptorchidism, the testicle was not descended into the scrotum and was fixed in the inguinal canal due to a deficiency in the length of the spermatic cord (SC). On examination, a testicle in the middle or lower third of the inguinal canal was found in 10 patients, at the root of the scrotum - in 7. In 5 patients, the testicle was not detected. The average period between the first and repeated surgery was 3 years (from 4 months to 8 years). Upon admission, all patients underwent a clinical examination, ultrasound examination of the inguinal canals, and a study of the hormonal profile if indicated. Results. After revision of the inguinal canal, 17 testicles were successfully re-descended using the Shemaker technique. Of these, 16 testicles were fixed in the scrotum, 1 testicle - at the root of the scrotum. During the second operation, the vaginal process of the peritoneum was found in 7 children. Laparoscopically-assisted orchipexy was performed in 3 patients. Orchiectomy was performed in 5 cases due to testicular atrophy. The duration of the surgery was 55-120 minutes. There was no intraoperative blood loss. In the long-term postoperative period (after a year or more), postoperative testicular atrophy was not detected.

Congenital abdominal wall defects and cryptorchidism: a population-based study

PurposeSeveral studies have reported high prevalence of undescended testis (UDT) among boys with congenital abdominal wall defects (AWD). Due to rarity of AWDs, however, true prevalence of testicular maldescent among these boys is not known. We conducted a national register study to determine the prevalence of UDT among Finnish males with an AWD.MethodsAll male infants with either gastroschisis or omphalocele born between Jan 1, 1998 and Dec 31, 2015 were identified in the Register of Congenital Malformations. The data on all performed operations were acquired from the Care Register for Health Care. The register data were examined for relevant UDT diagnosis and operation codes.ResultsWe identified 99 males with gastroschisis and 89 with omphalocele. UDT was diagnosed in 10 (10.1%) infants with gastroschisis and 22 (24.7%) with omphalocele. Majority of these required an operation; 8/99 (8.1%) gastroschisis and 19/89 (21.3%) omphalocele patients. UDT is more common among AWD patients than general population with the highest prevalence in omphalocele.ConclusionsCryptorchidism is more common among boys with an AWD than general population. Furthermore, omphalocele carries significantly higher risk of UDT and need for orchidopexy than gastroschisis. Due to high prevalence testicular maldescent, careful follow-up for UDT is recommended.

The Mechanism of Prune Belly Syndrome Development: A Sonographic Sequential Assessment

Prune belly syndrome is a rare disorder characterized by the absence of anterior abdominal wall muscles, bilateral cryptorchidism, and urinary tract malformations. The aim of this case study was to illustrate the developmental sequelae of prune belly syndrome, acquired through a series of antenatal sonography. A 20-year-old woman visited a diagnostic medical sonography center for an obstetrical sonogram. Her fetus was diagnosed with megacystis at 15 weeks’ gestation. The mother returned for repeated appointment and to observe fetal changes during the development of prune belly syndrome. First, the megacystis, hydroureter, and hydronephrosis were noted followed by hazy ascitic and amniotic fluid. The hemodynamics were altered in the umbilical artery, middle cerebral artery, and ductus venosus. Subsequently, the pressure was neutralized, but it was observed after birth that the newborn had cryptorchidism, a distended abdomen with wrinkled wall, and absent right kidney. In conclusion, prune belly syndrome could be caused by megacystis due to bladder outlet obstruction in otherwise normal karyotype fetuses. Megacystis leads to hydroureter, hydronephrosis, and abdominal distention. The persistent abdominal distention gives rise to the underdevelopment of anterior abdominal wall muscles and cryptorchidism.

V09-12 NON-PALPABLE TESTIS WITHIN A SPIGELIAN HERNIA: IDENTIFICATION AND LAPAROSCOPIC ORCHIOPEXY

INTRODUCTION AND OBJECTIVE:An association between abdominal wall defects and cryptorchidism has long been noted in the medical literature. Spigelian hernia (SH), although uncommon in pediatrics, is...

Нарушение формирования пола 46 XY и двусторонняя метахронная опухоль Вильмса у ребенка с мутацией в экзоне 7 гена WT1

Denys-Drash syndrome is characterized by a triad: nephropathy, a 46, XY disorder of sex development, and nephroblastoma with mutations in the gene WT1. A clinical case of a patient with a bilateral metachronous Wilms' tumor, a 46, XY disorder of sex development in the form of a scrotal hypospadias and bilateral abdominal cryptorchidism, without nephropathy with a mutation in 7 exon of gene WT1 is presented in the article. The child underwent left-sided nephrectomy, lower pole right partial nephrectomy, bilateral orchiopexy and two-stage correction of hypospadias. After 7 years from the start of treatment and 3 years after the last procedure, the childs condition has been assessed as satisfactory. The presented case, according to the analysis of literature, has not been previously described, therefore, it currently remains as "de novo" and requires further observation.

&lt;i&gt;WT1&lt;/i&gt; gene mutation in exone 7 in boy with disturbance of the sex formation and the bilateral nephroblastoma

The case of observing a patient with WT1 gene mutation in exone 7 with bilateral Wilms metachronous tumor, disturbance of the sex formation in the form of scrotal hypospadias and bilateral abdominal cryptorchidism, without nephropathy, is presented. The child underwent surgical operations: left-sided nephrectomy, resection of the lower pole of the right kidney, bilateral orchiopexy and two-stage hypospadias correction. 7 years after the start of treatment and 3 years after the final operation, the condition of the child was estimated as satisfactory. The presented case by the results of the molecular genetic study has no previously described analogues and requires further observation.

A PERSPECTIVE ON APPLICATION OF MESENCHYMAL STROMAL CELLS OR THEIR SECRETOME-BASED PRODUCTS FOR TREATING MALE INFERTILITY

The study revealed the regenerative effects of MSC and MSC secretome in a model of abdominal cryptorchidism in rats.

A magic kick for regeneration: role of mesenchymal stromal cell secretome in spermatogonial stem cell niche recovery

BackgroundInjury of stem cell niches may disturb tissue homeostasis and regeneration coordinated by specific niche components. Yet, the mechanisms of stem cell niche restoration remain poorly understood. Herein, we examined the role of mesenchymal stromal cells (MSCs) as pivotal regulators of stem cell niche recovery focusing on the effects of their secretome.MethodsThe spermatogonial stem cell (SSC) niche was selected as a model. SSC niches were injured by inducing abdominal cryptorchidism in rats. Briefly, testes of anesthetized rats were elevated into the abdominal cavity through the inguinal canal for 14 days. After descent of testes, MSC or MSC secretome treatment was applied to the animals by local subtunical injections.ResultsLocal administration of MSC or MSC secretome was sufficient to recover spermatogenesis and production of functional germ cells. The effects of MSC and their secreted components were comparable, leading to restoration of Sertoli cell pools and recovery of Leydig cell secretory functions.ConclusionOur data suggest that MSCs mimic the functions of lost supportive cells within the stem cell niche, transiently providing paracrine stimuli for target cells and triggering tissue regenerative processes after damage.

Abdominal cocoon with bilateral cryptorchidism and seminoma in the right testis: a case report and review of literature

BackgroundAbdominal cocoon is a rare peritoneal lesion and is difficult to diagnose because of its lack of special clinical manifestations. Until now, there is no case report of abdominal cocoon combined with cryptorchidism and seminoma.Case presentationA case of abdominal cocoon with cryptorchidism and seminoma was diagnosed and treated in our hospital. The patient had no symptoms except occasional abdominal pain. He underwent laparoscopy because of bilateral cryptorchidism and seminoma in the right testis. During the surgery, he was diagnosed with abdominal cocoon due to the thick fibrous tissues which was tightly adhered and encased part of intestine like a cocoon. Enterolysis and bilateral cryptochiectomy were performed after the diagnosis and nutritional and symptomatic support was provided after the surgery. The patient recovered well and was discharged soon. The postoperative pathological examination confirmed the presence of bilateral cryptorchidism and seminoma in the patient’s right testis.ConclusionThere are only a handful of cases where a patient has both abdominal cocoon and cryptorchidism. Since the etiologies of both diseases remain unknown, further research is required to investigate effective diagnosis and treatment for the diseases and explore the potential connection between the two diseases.