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Age of Undescended Testis Linked to Germ Cell Loss

Researchers also found a 50 percent greater risk of cell loss for nonpalpable testis pre-orchiopexy

MONDAY, July 20 (HealthDay News) -- In children with cryptorchidism, the longer an affected testis remains undescended, the greater the risk of the loss of germ cells and Leydig cells, according to a study in the August issue of the Journal of Urology.

Gregory E. Tasian, M.D., of the University of California in San Francisco, and colleagues analyzed biopsies of the testes of 274 children who underwent orchiopexy procedures between 1991 and 2001 to determine germ cell and Leydig cell loss and testicular fibrosis. The researchers used multivariable logistic regression to determine if factors such as age at the time of the procedure, testis palpability, unilateral or bilateral condition, or the side of the undescended testis could predict outcomes.

The researchers found that age at the time of orchiopexy was associated with the degree of germ and Leydig cell depletion. For each month during which the testis remained undescended there was a 2 percent risk of severe germ cell loss and 1 percent risk of Leydig cell loss. The authors further note that there was a 50 percent greater risk of severe germ cell depletion for nonpalpable testis compared to palpable testes, but no association between palpability of the testis and loss of Leydig cells.

"Patient age and the ability to palpate a cryptorchid testis predict histological changes found on testicular biopsies performed at orchiectomy. Testes that remain undescended are associated with progressive loss of germ and Leydig cells, and nonpalpable testes predict severe germ cell loss," the authors conclude.

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