Unilateral Abdominal Cryptorchidism Research Articles

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 The abdominal testis was endoscopically located and grasped, the cannula was retracted, the capnoperitoneum was reversed to allow exteriorization of the testis, and the spermatic cord was ligated extracorporeally.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.

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.

Testicular Teratoma in a Unilateral Right-Sided Abdominal Cryptorchid Horse

Background: Cryptorchidism is characterized by the incomplete descent of one or both testicles to the scrotum, being a hereditary alteration and frequently an unilateral condition. Besides the sexual and aggressive behaviour, the retained testicle is commonly located in abdominal cavity, being considered a risk factor for neoplasm development. The most common testicular neoplasm reported in mammalian species are Sertoli cell tumors, Leydig cell tumors, seminomas and teratomas. A presumptive diagnosis of testicular tumor can be achieved by ultrasonography, although the definitive diagnosis is obtained only by histopathology. In this report, we are presenting a of testicular teratoma in an unilateral abdominal cryptorchid horse. Case: A stallion, American Quarter Horse, 3 year-old, was attended and presented right testicle retained and a left testicle in the scrotum. Transrectal palpation was used to identify a round and firm structure, presumably the right testicle, lateral to the urinary bladder and located in the right side of the abdomen. Further, a transrectal ultrasound examination showed a complex, round mass with irregular edges containing both cystic and solid structures, hypoechoic fluid-filled cavities separated by linear hyperechoic septa. After a clinical examination, the animal was diagnosed with cryptorchidism and was submitted to orchiectomy and cryptorchidectomy by inguinal approach. Surgery was performed under general anesthesia and postoperative care included cold shower, anti-inflammatory and antibiotic therapy. Testicles were surgically removed and further sent for histopathological examination. The visual appearance of the right undescended testicle showed multiple round, cystic, and solid structures on outer surface, while the left descended testicle was apparently normal. The macroscopic evaluation showed that the affected testicle consisted of a firm to soft solid mass with multiple fluid-filled cystic areas. Microscopically, the testicular architecture was replaced by cysts, fibrous tissue, adipose tissue, glandular structures, and foci of calcification. The histology revealed that the retained testicle had a testicular teratoma. Discussion: Reproductive disorders are common in horses and represent a significant part of the equine practitioner routine. Equine cryptorchidism is the most common non-lethal developmental defect of stallions; Surgery is the best treatment, since this alteration is hereditary. Teratomas have been reported more often in cryptorchid testicles, being usually just diagnosed as an incidental finding during surgical procedure. Under field conditions, usually the testicles are not sent for histopathological evaluation and this fact can contribute to underdiagnoses. Ultrasonography allows clinicians to determine testis location as well as morphological changes in the testes, as well as to elaborate a presumptive diagnose of testicular neoplasm. Histopathology is the best exam to achieve definitive diagnoses in the presence of testicular alterations. In our report, diagnosis of testicular neoplasia was not made before surgery and testicular mass was an incidental finding during the pre-surgical examination. Before testicular enlargement or presence of testicular mass, neoplasia should be included in the differential diagnosis. In conclusion, although rare, teratoma should be included in differential diagnoses of retained testicles, especially those with morphological alterations.

Effects of body temperature on the expression and localization of meiosis-related proteins STRA8 and SCP3 in boar testes

Body temperature could lead to interruption of spermatogenesis, but the molecular mechanism was still unclear. Cryptorchidism was defined as the failure of testes to enter the scrotum, which exposed the testes to body temperature. Meiosis was a unique feature of germ cell development. Whether cryptorchidism damage the initiation of meiosis in boars had not been reported. The aim of this study was to determine whether spermatogonia in the cryptorchid testes entered into meiosis by detecting meiosis-related markers stimulated by retinoic acid gene 8 (STRA8) and synaptonemal complex protein 3 (SCP3). Three boars with spontaneous unilateral abdominal cryptorchidism were used. The testis located in the abdomen was cryptorchidism group, the scrotal testis of the same animal was used as control. HE results showed that only Sertoli cells, and a few spermatogonia remained in the seminiferous tubules, and no spermatids were seen compared with the control. Immunohistochemistry results showed that in both control and cryptorchidism group, STRA8 was mainly expressed in the nucleus of spermatogonia and spermatocytes. In control group, SCP3 was expressed in the nucleus of spermatocytes. In cryptorchidism group, SCP3 immunopositive cells were also observed. qRT-PCR and Western Blot results showed that the mRNA and protein levels of STRA8 and SCP3 were significantly decreased in cryptorchid boars. The expression of STRA8 and SCP3 in cryptorchidism suggested that spermatogonia could still enter meiosis in cryptorchid boars.

Cystic intra‐abdominal testicles: Standing laparoscopic removal in two colts

SummaryThis case report describes the laparoscopic approach for removal of cystic intra‐abdominal testicles in the standing colt. One 3‐year‐old Tobiano and one 2‐year‐old Warmblood colts were referred for abdominal cryptorchidectomy. The horses were clinically and ultrasonographically examined and a presumptive diagnosis of unilateral abdominal cryptorchidism was made. A laparoscopic approach via the flank was used to localise each abdominal testicle. In both colts the abdominal testicle was enlarged and cystic. Each spermatic cord was ligated and fluid was aspirated from the testicle. By reducing the size of the mass minimally invasive removal through an enlarged instrumental portal was possible. Histopathology revealed a cystic rete testis in the Tobiano and a teratoma in the Warmblood. In these cases the cystic enlarged testicles were nonpainful and were incidental findings. A cystic testicle might be developmental (Tobiano case) or arise due to neoplastic transformation (Warmblood case). The laparoscopic approach for enlarged cyst‐like testicles in the standing horse offers a secure minimally invasive method for removal.

The expressions in oxytocin and sex steroid receptors in the reproductive tissues of normal and unilateral cryptorchid dogs

In males, oxytocin is involved with various physiological functions, such as reproductive tract contractility and testicular steroidogenesis. Due to the relationship between sex steroid hormones, oxytocin receptor (OTR) expression and cryptorchidism pathogenesis, this study aimed to investigate the mRNA expression and the localization of OTR in relation to sex steroid receptors in the male reproductive tract of both normal and unilateral abdominal cryptorchid dogs using quantitative PCR and immunohistochemistry. Male dogs were divided into two groups of normal and cryptorchid dogs. Samples from each cryptorchid dog were separated into two subgroups: scrotal and abdominal subgroups. The results showed that a lower percentage of positive OTR immunostaining in the testis and epididymis was observed in the cryptorchid group compared to the normal group. Within the cryptorchid group, the mRNA expression and the localization of OTR in the testis and epididymis of the abdominal subgroup was less than that of the scrotal subgroup. Moreover, the localization of OTR and estrogen receptor beta (ERβ) in reproductive tissues was positively correlated only in the normal group and not in the cryptorchid group. In conclusion, this study proposed that OTR expression, as well as the correlation between the OTR and ERβ in reproductive tissues of male dogs, can be disturbed by cryptorchidism. Furthermore, the OTR, ERβ and their correlation may be involved with the pathogenesis of cryptorchidism. Therefore, the study of gene knockout models to confirm the effect of OTR and sex steroid receptors on canine cryptorchidism should be of interest for further investigation.

Comparison of Peritoneal Fluid Values after Laparoscopic Cryptorchidectomy using a Vessel‐Sealing Device (Ligasure™) Versus a Ligating Loop and Removal of the Descended Testis

To determine the effect of unilateral laparoscopic cryptorchidectomy and removal of the descended testis on peritoneal fluid values, and to compare effect between 2 methods for cryptorchid testis vessel hemostasis. Randomized clinical study. Stallions (n = 10) with unilateral abdominal cryptorchid testis. During standing laparoscopic cryptorchidectomy, blood vessels within the mesorchium of the cryptorchid testis were either sealed and transected with the LigaSure Atlas™ or 2 ligating loops were placed proximal to the testis and the tissue transected with laparoscopic scissors. The testis was removed through the body wall. After laparoscopic cryptorchidectomy, stallions were anesthetized and the descended testis was removed using a closed technique leaving the scrotal incision open. Abdominocenteses were performed before surgery, and 24, and 72 hours after surgery. Values for peritoneal total nucleated cell count (TNCC), total protein concentration (TP), and red blood cell count (RBCC) were all elevated at 24 and 72 hours when compared with baseline. Median TNCC for LigaSure™ (59,780 cells/μL) was nearly twice that of the ligating loop (32,880 cells/μL) at 24 hours postoperatively. There was no statistically significant difference in TNCC, TP, or RBCC between groups. TNCC, TP, and RBCC increase appreciably from baseline 24 hours after laparoscopic cryptorchidectomy and closed castration but are markedly reduced by 72 hours.

Laparoscopic-assisted diagnosis of anomalous unilateral abdominal cryptorchidism

This report describes an unusual case of unilateral abdominal cryptorchidism in a Shetland pony. On the cryptorchid side, no testicular structures were present in the inguinal area but testicular/epididymal remnants at the distal end of a pedunculated structure could be discerned in the abdomen at laparoscopic examination. Furthermore, the deferent duct was disconnected from the epididymal remnants and the deferent duct was visible at the caudal aspect of the bladder, traversing over the lateral ligament of the bladder into the vaginal ring where it ended blindly in the vaginal process. After laparoscopic removal of the testicular/epididymal remnants and castration of the contralateral normally descended testicle, the hCG stimulation test was negative and the pony no longer exhibited masculine behaviour.

Lectin affinity of the seminiferous epithelium in healthy and cryptorchid post‐pubertal boars

The present study describes the sugar content of the seminiferous epithelium, using lectin histochemistry, in healthy boars and in boars with unilateral and bilateral abdominal cryptorchidism. In healthy boars the apical cytoplasm of Sertoli cells exhibited abundant glucosyl (Con A and WGA lectins), galactosyl (HPA, DBA, SBA and PNA lectins), and fucosyl (AAA lectin) residues. Spermatogonia and spermatocytes contained abundant glucosyl (Con A and WGA lectins) and fucosyl (AAA lectin) residues. In spermatids, galactosyl (SBA and PNA lectins) and glucosyl (Con A and WGA lectins) residues increased progressively throughout spermiogenesis, and fucosyl (AAA lectin) residues decreased. As compared with healthy boars, the scrotal testis of unilateral cryptorchid boars showed decreased amounts of fucosyl (AAA lectin) and galactosyl (HPA and DBA lectins) residues on the Sertoli cell apical cytoplasm; spermatocytes exhibited higher content of glucosyl (Con A lectin) residues and spermatids showed altered nature of glucosyl (Con A and WGA lectins) and galactosyl (SBA and PNA lectins) complexes. In abdominal testes of unilateral and bilateral cryptorchid boars, immature Sertoli cells and spermatogonia showed decreased fucosyl (AAA lectin), and increased glucosyl (Con A and WGA lectins) and galactosyl (SBA and PNA lectins) contents. These results suggest that the seminiferous epithelium of healthy boars has polarized activity with the apical compartment implicated in germ cell-Sertoli cell adhesion and interaction, in transport of ions, substrates and fluids, and in acrosomal differentiation. In scrotal testes, unilateral abdominal cryptorchidism could lead to defective germ cell-Sertoli cell adhesion, impaired acrosomal differentiation and increased ionic transport in the apical compartment of the seminiferous epithelium. Unilateral and bilateral cryptorchidism could induce increased ionic transport and membrane permeability in the seminiferous epithelium of abdominal testes.

Cytology of the interstitial tissue in scrotal and abdominal testes of post-puberal boars

The interstitial tissue of the testes from healthy boars, and unilateral and bilateral abdominal cryptorchid boars was examined by light and transmission electron microscopy. The left and right testes of healthy boars, and the left (scrotal) testis of unilateral cryptorchid boars had abundant mature Leydig cells, few fibroblasts and mast cells, scarce and small blood vessels, and little lymphatic areas. The right (abdominal) testis of unilateral cryptorchid boars contained abundant Leydig cells, fibroblasts and erythrocytes, scarce mast cells, and frequent blood vessels; Leydig cells exhibited either a mature but degenerative appearance or an immature appearance, and fibroblasts displayed immaturity signs. The interstitial tissue of the left (abdominal) testes of bilateral cryptorchid boars had small blood vessels surrounded by erythrocytes, lymphocytes, and few plasma cells, and abundant mature and immature Leydig cells, immature fibroblasts, and mast cells. Mature Leydig cells showed mid or advanced degeneration, and immature Leydig cells displayed either non-degenerative or degenerative patterns. The right (abdominal) testes of bilateral cryptorchid boars contained scarce immature Leydig cells in advanced degeneration, large fibrous and adipose areas, and blood vessels. These results indicated that unilateral abdominal cryptorchidism affect neither the structural nor the cytologic features of the interstitial tissue in scrotal testes. Unilateral and bilateral cryptorchidism induced abnormal differentiation of Leydig cells and fibroblasts leading to decreased steroid production and increased collagenization in abdominal testes.

Efficiency of the process of meiosis in scrotal testes of healthy boars and unilateral abdominal cryptorchid boars.

Unilateral abdominal cryptorchidism has usually been correlated with abnormalities in the spermatogenic activity of the scrotal testis. The present study describes the effects of unilateral abdominal cryptorchidism on the meiotic process in scrotal testes from postpubertal boars. The percentage of primary spermatocytes, secondary spermatocytes, and round spermatids was evaluated in testicular smears from scrotal testes of healthy boars and of right-sided unilateral abdominal cryptorchid boars. As compared to the scrotal testes of healthy boars, the scrotal testes of unilateral abdominal cryptorchid boars showed low transformation from primary to secondary spermatocytes (meiosis I), but normal transformation from secondary spermatocytes to round spermatids (meiosis II). The data obtained indicate that spontaneous unilateral abdominal cryptorchidism on the right side induced partial arrest of spermatogenesis at the primary spermatocyte stage that was attributed to anomalies in Sertoli-cell activity. Abnormal paracrine signals from altered Sertoli cells could have resulted in either disturbed mitosis, which led to the formation of spermatocytes with an abnormal DNA content, or abnormalities in the metabolic activity and the organization of the cytoskeleton of primary spermatocytes.

P-002. Testicular structure in spontaneous unilateral and bilateral abdominal cryptorchidism

P-002. Testicular structure in spontaneous unilateral and bilateral abdominal cryptorchidism

Characterization of the semen quality of postpuberal boars with spontaneous unilateral abdominal cryptorchidism on the right side.

In recent studies, we found that the ectopic testis from postpuberal boars with unilateral abdominal cryptorchidism does not produce sperm. Therefore, in these males, the seminal characteristics can be used as indicators of the activity of the scrotal testis and its epididymis and also the accessory glands. The semen quality (ejaculate volume, cell-rich fraction volume, sperm concentration, sperm vitality, sperm motility, sperm morphology and cephalic stability of spermatozoa) was evaluated in healthy postpuberal boars and in postpuberal boars with unilateral abdominal cryptorchidism on the right side. In comparison with the healthy boars, the unilateral abdominal cryptorchid boars showed a significant decrease of the ejaculate volume, sperm concentration and sperm motility. The low sperm concentration indicated that unilateral abdominal cryptorchidism severely impairs the sperm production of the scrotal testis. The decrease of ejaculate volume was attributed to an abnormal activity of the accessory glands. The alterations in sperm motility develop as a result of dysfunctions in the epididymal epithelium and/or the accessory glands. The sperm vitality, sperm morphology and cephalic stability of spermatozoa maintained normal values; therefore, at testicular level, despite the low sperm production, the germ cell differentiation is not disturbed. At epididymal level, the morphological maturation of spermatozoa is not altered.

Morphologic study of the testes from spontaneous unilateral and bilateral abdominal cryptorchid boars.

Macroscopical and histological characteristics were examined in both testes from three healthy boars, three boars with unilateral abdominal cryptorchidism on the right side, and three boars with bilateral abdominal cryptorchidism. Abdominal cryptorchidism, unilateral and bilateral, provoked a significant decrease of the weight and volume of the ectopic testes. The scrotal testis of the unilateral cryptorchid boars showed an increase in its volume and weight. Cryptorchidism also induced abnormalities in the histological structure of seminiferous tubules, lamina propria, and interstitial tissue of the abdominal testes. The number of seminiferous tubules decreased; the seminiferous epithelium was constituted by few spermatogonia with an atypical pattern and by abnormal Sertoli cells. The lamina propria showed a variable degree of thickening and collagenization. The interstitial tissue was very developed but displayed a decrease in the Leydig cell population. These abnormalities were more critical in bilateral cryptorchidism than in unilateral cryptorchidism. The scrotal testis of the unilateral cryptorchid boars showed normal appearance, but a decrease of the number of seminiferous tubules was observed. Moreover, the seminiferous tubules showed impaired spermatid maturation. The alterations observed in the abdominal testes of the unilateral and bilateral cryptorchid boars were attributed to defective proliferation and differentiation of Sertoli cells and Leydig cells. The anomalies in the scrotal testis of the unilateral cryptorchid boars were due to disturbances in the Sertoli cell activity.

Degenerative Changes in Spermatogonia Are Associated with Loss of Glucose Transporter (Glut 3) in Abdominal Testis of Surgically Induced Unilateral Cryptorchidism in Rats

Expression of facilitative glucose transporters (Glut 1, 2 and 3) was examined by Western blot analyses 10, 20 and 30 days following surgically induced unilateral abdominal cryptorchidism. The cryptorchid testes exhibited marked degenerative changes in the seminiferous tubules and spermatogonia, impaired and incomplete spermatogenesis and lack of spermatozoa in the lumen. Immunoblotting of testis proteins with Glut transporter antibodies revealed only the presence of Glut 2 and 3 protiens. Glut 2 expression in abdominal testis was increased (45%, 67%, and 40% at 10, 20 and 30 days, respectively) but no significant change was observed in contralateral scrotal testis. Glut 3 expression was reduced by 85-95% compared with contralateral scrotal testis. A significant decrease in Glut 3 levels in abdominal testis was accompanied by an increase in scrotal testis Glut 3 content (80%, 144% and 212% at 10, 20 and 30 days, respectively) compared to age matched control rats. These results suggested that the degenerative changes in abdominal testis may be associated with decreased Glut 3 mediated glucose transport in seminiferous tubules and spermatogonia.

Sperm quality in spontaneous unilateral abdominal cryptorchid boars.

Sperm quality in spontaneous unilateral abdominal cryptorchid boars.

Concentrations of oestradiol and testosterone in peripheral and spermatic venous blood of dogs with unilateral cryptorchidism

Plasma testosterone and oestradiol concentrations were measured in peripheral and spermatic venous blood of 13 dogs with unilateral inguinal cryptorchidism, 9 dogs with unilateral abdominal cryptorchidism, and in a control group of 36 mature normal dogs. The hormone concentrations were similar in the three groups, both in the peripheral and in the spermatic venous blood. The weight of the testes in the control group was correlated with the body weight and there was no significant difference between the weight of the right and the left testes. The weight of the abdominal testes was lower than that of the inguinal testes, and there was no compensatory enlargement of the contralateral scrotal testis. The cryptorchid testes showed little or no histological evidence of spermatogenesis, and spermatogenesis was usually normal in the scrotal testes.

停留睾丸の研究

Diagnosis of inguinal testis is easy, but that of abdominal testicle, especially when it is unilateral, is frequently difficult. Bilateral abdominal testes can be diagnosed by endocrinological studies (17), while unilateral abdominal testicle cannot be found any where and often requires exploratory laparotomy.Pelvic pneumography has been used for gynecological disorders to visualize the intrapelvic strcutures. Pneumography would be a safe, simple and nonsurgical technique not only for adults but also for children (12).We applied the pelvic Pneumography to 9 unilateral abdominal cryptorchid boys (age 4 to 11 yrs.) and diagnostic value was discussed. The patient was placed in supine position, a Teflon needle is entered to the peritoneal cavity in the midline below the umbilicus. A total of 600 to 1000ml, of carbon dioxide is introduced into the pelvic space. Tympanitic percussion is a most useful sign of adequate filling. Films are taken in prone and head-down position.No complications have been experienced in our cases.3 out of 9 patients were found positive for gonadal shadows on pelvic pneumography (Fig. 2, 3 and 4). These gonads were confirmed by surgery successively.Other 6 cases were negative for gonads on pneumography.Thus, our pelvic pneumography in unilateral abdominal cryptorchid children showed accurate findings. It seems to us that this method is a most useful and valuable technique for diagnostic studies before surgery.