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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

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.

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Correspondence to R. Mieusset.

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Mieusset, R. Anomalies de position des testicules dans l’enfance: conséquences à l’âge adulte. Androl. 9, 272 (1999). https://doi.org/10.1007/BF03035239

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Mots clés

  • testicules non descendus
  • cancer du testicule
  • spermatogenèse
  • volume testiculaire
  • spermiologie
  • infécondité masculine

Key-words

  • non descended testes
  • testis cancer
  • spermatogenesis
  • testicular volume
  • sperm analyses
  • male infertility