Long-term morphofunctional outcomes of treating cryptorchidism complicated by torsion of the undescended testis
DOI:
https://doi.org/10.15574/PS.2026.1(90).7681Keywords:
testicular torsion, cryptorchidism, young adults, fertility, long-term outcomesAbstract
Testicular torsion is generally a rare condition; however, its risk is significantly increased in patients with cryptorchidism. Testicular torsion occurs approximately 10 times more frequently in patients with cryptorchidism compared to those with descended testes.
Aim - to evaluate and compare the long-term morphofunctional status of the testes and fertility parameters in young men who underwent either elective orchiopexy in childhood or orchiopexy complicated by torsion of the undescended testis.
Materials and methods. Data from 37 men (aged 18-25) with a history of unilateral inguinal cryptorchidism were analyzed. Group I consisted of 28 patients after elective orchiopexy, and Group II included 9 individuals whose condition was complicated by testicular torsion. Intratesticular blood flow (Doppler ultrasound) and ejaculate parameters were evaluated.
Results. In young men, worse blood flow parameters were recorded after the treatment of torsion (Group II) than after elective surgery. Specifically, a significant increase in the resistance index in intratesticular arteries was diagnosed in both groups compared to healthy controls: 0.72 (0.66; 0.75), and 0.76 (0.62; 0.79), versus 0.67 (0.59; 0.7). The criteria for effective treatment of testicular diseases are their adequate functional capacity - fertility and hormonal function. A particular impairment in patients with torsion of an undescended testis was noted in the percentage of spermatozoa with normal morphology - 5.05% (3.15; 8.2) and 30.1% (15.1; 58.9). The orchiopexy only group had a statistically significantly better result, although it also did not reach the normal range - 27.2% (17.3; 45.5).
Conclusions. It is necessary to prioritize early diagnosis of testicular torsion in cryptorchidism and implement immediate surgical intervention to prevent irreversible parenchymal damage. Even timely surgical treatment for torsion of an undescended testis significantly worsens the morphofunctional characteristics of the testicles in this congenital condition. Early orchiopexy in patients with cryptorchidism minimizes the risk of torsion. Given the severe complications arising from testicular torsion, it is advisable to perform prophylactic fixation of the contralateral testis as a planned procedure for patients with a history of this pathology.
The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work.
The authors declare no conflict of interest.
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