- Cryptorchidie
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Anomalies de position des testicules dans l’enfance: conséquences à l’âge adulte
Anomalies of testis position during childhood: consequences in adult life
Andrologie volume 9, pages 272–285 (1999)
Résumé
La non descente des testicules en situation scrotale basse à la naissance est une anomalie fréquente, estimée à 4% des naissances masculines. Seul un quart de ces enfants resteront avec un testicule non descendu à l’âge de un an. Toutefois, les testicules qui descendent au cours de la première année de vie semblent ne plus pouvoir être considérés comme des testicules normalement descendus. Il en est de même pour les testicules rétractiles, anomalie secondaire de position survenant au-delà de la première année de vie.
Les conséquences de la non descente des testicules à l’âge de un an sont doubles: elle constitue le seul facteur de risque identifié du cancer du testicule; elle représente un facteur de risque pour la fertilité masculine avec des altérations de la spermatogenèse (histologiques, spermiologiques) et une réduction de la fécondité.
Abstract
Non descended testes in the low scrotum is a common anomaly at birth, with about 4% of the newborn males affected. Only one quarter of these newborn babies will still have non descended testes when one year old. However, the testes that will descend within the first year of life seem no more to be considered as normally descended testes. Moreover, the retractile testis, which represents a secondary anomaly of testicular position occuring after the babies are older than one year, is no more to be regarded as a physiological variant of the normally descended testis, since several reports indicate histological and clinical modifications in such cases.
The testicular non descent can be associated with two consequences in adult life. Firstly, an history of non descended testis is the only known risk factor for the testicular cancer. Secondly, such an history is a risk factor for the male fertility because of spermatogenesis alterations, as indicated by qualitative and quantitative histological analyses of the testicular tissue, and by depressed spermatozoa output and quality (motility, normal forms); moreover, testicular volumes are reduced, and the time to pregnancy as well as the rate of infertility are increased.
Time is arrived for a reappraisal of the consequences in adult life of the abnormal testicular location (either congenital or acquired) during childhood.
References
ATWELL J.D.: Ascent of the testis. Fact or fiction. Br. J. Urol., 1985, 57: 474–477.
BAIKIE G., HUTSON J.M.: Wolffian duct and epididymal agenesis fails to prevent testicular descent. Pediatr. Surg. Int., 1990, 5: 458–462.
BELMAN A.B.: Acquired undescended (ascended) testis: effects of human chorionic gonadotropin. J. Urol., 1988, 140: 1189–1190.
BERKOWITZ G.S., LAPINSKI R.H., DOGLIN S.E., GAZELIA J.G., BODIAN C.A., HOLZMAN I.R.: Prevalence and natural history of cryptorchidism. Pediatrics, 1993, 92: 44–49.
BUEMANN B., HENRIKSEN H., VILLUMSEN A.L., WESTH A., ZACHAU-CHRISTIANSEN B.: Incidence of undescended testis in the newborn. Acta Chir. Scand., 1961, 283 suppl.: 289–293.
CAMPBELL H.E.: Incidence of malignant growth of the undesended testis. Arch. Surg., 1942, 44: 353–369.
CARRAGHER A.M., McLEAN R.D.W.: Familial bilateral cryptorchidism. B.J.C.P., 1990, 44: 688–689.
CAZALS S., BUJAN L., MIEUSSET R.: données non publiées, 1999.
CHILVERS C., PIKE M.C.: Cancer risk in the undescended testicle. Eur. Urol. Update Series, 1992, 1: 74–79.
CHILVERS C., PIKE M.C., FORMAN D., FOGELMAN K., WADWORTH M.E.J.: Apparent doubling of frequency of undescended testis in England and Wales in 1962–81. Lancet, 1984, 2: 330–332.
CHILVERS C., DUDLEY N.E., COUGH M.H., JACKSON M.B., PIKE M.C.: Undescended testis: the effect of treatment on subsequent risk of subfertility and malignancy. J. Pediatr. Surg., 1986, 21: 691–696.
CLARNETTE T.D., ROWE D., HASTHORPE S., HUSON J.M.: Incomplete disappearence of the processus vaginalis as a cause of ascending testis. J. Urol., 1997, 157: 1889–1891.
CORTES D., THORUP J.M., LINDENBERG S.: Fertility potential after unilateral orchidopexy: simultaneous testicular biopsy and orchidopexy in a cohort of 87 patients. J. Urol., 1996, 155: 1061–1065.
EARDLEY A.B., SAW D.R.R., WHITAKER R.H.: Surgical outcome of orchidopexy. II Trapped and ascending testes. Br. J. Urol., 1994, 73: 204–206.
FALLON B., KENNEDY T.J.: Long-term follow-up of fertility in cryptorchid patients. Urol., 1985, 25: 502–504.
GARCIA-RODRIGUEZ J., GARCIA-MARTIN M., NOGUERAS-OCANA M. et al.: Exposure to pesticides and cryptorchidism: geographical evidence of a possible action. Environ. Health Perspect., 1996, 104: 1090–1095.
GILHOOLY P.E., MEYERS F., LATTIMER J.K.: Fertility prospects for children with cryptorchidism. Amer. J. Dis. Child., 1984, 138: 940–943.
GILL W.B., SCHUMACHER G.F.B., BIBBO M., STRAUSS F.H.I., SCHOENBERG H.W.: Association of diethylstilbestrol exposure in utero with cryptorchidism, testicular hypoplasia and semen abnormalitites. J. Urol., 1979, 122: 36–69.
GIWERCMAN A., BRUUN E., FRIMODT-MÖLLER C., SKAKKEBAEK N.E.: Prevalence of carcinoma in situ and other histopathological abnormalities in testes of men with a history of cryptorchidism. J. Urol., 1989, 142: 988–1002.
GOH D.W., HUTSON J.M.: Is the retractile testis a normal physiological variant or an anomaly that requires active treatment? Pediatr. Surg. Int., 1992, 7: 249–252.
GOH D.W., HUTSON J.M.: The retractile testis: time for reappraisal. J. Paediatr. Child Health. 1993, 29: 407–408.
HADISELIMOVIC F., HERZOG B., HÖCHT B., HECKER E., MIESCHER E., BUSER M.: Screening for cryptorchid boys risking sterility and results of longterm buserilin treatment after successful orchiopexy. Eur. J. Pediatr., 1987, 146 suppl: S59-S62.
HEYNS C.F.: The gubernaculum during descent in human fetus. J. Anat., 1987, 153: 93–112.
JOHN RADCLIFF HOSPITAL CRYPTORCHIDISM STUDY GROUP: Boys with late descending testes: the source of patients with “retractile” testes undergoing orchidopexy? Br. Med. J., 1986, 293: 789–790.
JOHN RADCLIFF HOSPITAL CRYPTORCHIDISM STUDY GROUP: Cryptorchidism: a prospective study of 7500 consecutive male births, 1984–8. Arch. Dis. Child., 1992, 67: 892–899.
JONES I.R.G., YOUNG I.D.: Familial incidence of cryptorchidism. J. Urol., 1982, 127: 508–509.
LAIS A., CATERINO S., TALAMO M., NAHOM A., BAGOLAN P., FERRO F.: The gliding testis: minor degree of true undescended testis? Eur. J. Pediatr., 1993, 152, suppl 2: S20-S22.
LEE A.P., O’LEARY L.A., SONGER N.J.S., BELLINGER M.F., LAPORTE R.E.: Paternity after cryptorchidism: lack of correlation with age at orchidopexy. Br. J. Urol., 1995, 75: 704–707.
LEE A.P., O’LEARY L.A., SONGER N.J.S. et al.: Paternity after unilateral cryptorchidism: a controlled study. Pediatrics, 1996, 98: 676–679.
LEE A.P., O’LEARY L.A., SONGER N.J.S., COUGHLIN M.T., BELLINGER M.F., LAPORTE R.E.: Paternity after bilateral cryptorchidism. A controlled study. Arch. Pediatr. Adolesc. Med., 1997, 151: 260–263.
LENZI A., GANDINI L., Iombardo F. et al.: Unilateral cryptorchidism corrected in prepubertal age: evaluation of sperm parameters, hormones, and anti-sperm antibodies in adult age. Fertil. Steril., 1997, 67: 943–948.
LIPSHULTZ L.I.: Cryptorchidism in subfertile men. Fertil. Steril., 1976, 27: 609–620.
MANDAT K.M., WIECZORKIEWICZ B., GUBALA KACALA M., SNIPIEWSKI J., BUJOK G.: Semen analysis of patients who had orchidopexy in childhood. Eur. J. Pediatr. Surg., 1994, 34: 195–201.
MAU G., SCHNAKENBURG K.: Maldescent of the testes — an epidemiological study. Eur. J. Pediatr., 1977, 126: 77–84.
MIEUSSET R., BUJAN L., MASSAT G. et al.: Clinical and biological characteristics of infertile men with a history of cryptorchidism. Hum. Reprod., 1995, 10: 613–619.
MIEUSSET R., BUJAN L., MASSAT G., MANSAT A., PONTONNIER F.: Inconstant ascending testis as a potential risk factor for spermatogenesis in infertile men with no history of cryptorchidism. Hum. Reprod., 1997, 12: 974–979.
MORLEY R., LUCAS A.: Undescended testis in low birthweight infants. Br. Med. J., 1987, 295: 753.
MYERS N.A., OFFICER C.B.: Undescended testis: congenital or acquired? Aust. Paed. J., 1975, 11: 76–78.
OKUYAMA A., NONOMURA N., NAKAMURA M. ET AL.: Surgical management of undescended testis: retrospective study of potential fertility in 2274 cases. J. Urol., 1989, 142: 749–751.
PARKINSON M.C., SWERDLOW A.J., PIKE M.C.: Carcinoma in situ in boys with cryptorchidism: when can it be detected? Br. J. Urol., 1994, 73: 431–435.
PURI P., SPARNON A.: Relationship of primary site of testis to final testicular size in cryptorchid patients. Br. J. Urol., 1990, 66: 208–210.
RABINOVITZ R., HULBERT W.C.: Late presentation of cryptorchidism: the etiology of testicular reascent. J. Urol., 1997, 157: 1982–1984.
ROBERTSON J.F.R., AZMY A.F., COCHRAN W.: Ascent to ascent of the testis. Br. J. Urol., 1988, 61: 146–147.
SAMPAIO F.J.B., FAVORITO L.A.: Analysis of testicular migration during the fetal period in humans. J. Urol., 1998, 159: 540–542.
SCHIFFER K.A., KOGAN S.J., REDA E.F., LEVITT S.B.: Acquired undescended testes. Amer. J. Dis. Child., 1987, 141: 106–107.
SCORER C.G.: The incidence of incomplete descent of the testicle at birth. Arch. Dis. Child., 1956, 31: 198–202.
SCORER C.G.: The descent of the testis. Arch. Dis. Child., 1964, 39: 6005–609.
SIMPSON A.S., LAUGESEN M., SILVA P.A., STEWART C., WALTON J.: The prevalence of retained testis in Dunedin. N. Z. Med. J., 1985, 98: 758–760.
SULTAN C.: L’endocrinologie de la cryptorchidie. Andrologie, 1997, 7: 481–487.
SULTAN C., LUMBROSO S.: Cryptorchidie de l’enfant: syndrome ou symptôme? Andrologie, 1995, 5: 309–316.
SWERDLOW A.J., MELZER D.: The value of England and Wales congenital malformation notification scheme data for epidemiology: male genital tract malformations. J. Epidemiol. Community Health, 1988, 42: 8–13.
SWERDLOW A.J., HIGGINS C.D., PIKE M.C.: Risk of testicular cancer in cohort of boys with cryptorchidism. Br. Med. J., 1997, 314: 1507–1511.
TASKINEN S., WIKSTRÖM S.: Effect of age at operation, location of testis and preoprative hormonal treatment on testicular growth after cryptorchidism. J. Urol., 1997, 158: 471–473.
UNITED KINGDOM TESTICULAR CANCER STUDY GROUP: Aetiology of testicular cancer: association with congenital abnormalities, age at puberty, infertility, and exercise. Br. Med. J., 1994, 308: 1393–1397.
VENDRELY E.: La descente testiculaire. Andrologie, 1995; 5: 303–308.
VILLUMSEN A.L., ZACHAU-CHRISTIANSEN B.: Spontaneous alterations in position of the testes. Arch. Dis. Child., 1996, 41: 198–200.
WYLLIE C.G.: The retractile testis. Med. J. Aust., 1984, 10: 403–405.
WRIGHT J.E.: Testes do ascend. Pediatr. Surg. Int., 1989, 4: 269–272.
YAVETZ H., HARASH B., PAZ G. et al.: Cryptorchidism: incidence and sperm quality in infertile men; Andrologia, 1992, 24: 293–297.
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Mieusset, R. Anomalies de position des testicules dans l’enfance: conséquences à l’âge adulte. Androl. 9, 272–285 (1999). https://doi.org/10.1007/BF03035239
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DOI: https://doi.org/10.1007/BF03035239
Mots clés
- testicules non descendus
- cancer du testicule
- spermatogenèse
- volume testiculaire
- spermiologie
- infécondité masculine