隐睾患儿手术治疗后青春期性发育的临床和内分泌观察

第10卷　第7期中华男科学杂志

Vol.10　No.7

2004年7月

National Journal of Andrology

Jul.2004

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隐睾患儿手术治疗后青春期性发育

的临床和内分泌观察

丁德刚,李启忠,范小玲,杜　涛

(河南省人民医院泌尿外科,河南郑州450003)

摘要:　目的:观察隐睾患儿术后青春期性发育的状况。　方法:随访调查184例隐睾患儿术后青春期阴毛发育程度、阴茎长度和周径、睾丸体积和血清黄体生成素(LH )、卵泡刺激素(FSH )、睾酮(T )水平。比较不同手术年龄、隐睾位置和手术方式对疗效的影响。　结果:①双侧隐睾固定术组的阴毛发育程度、阴茎长度和周径、睾丸体积和T 明显降低;FSH 和LH 明显升高。②单侧隐睾固定术组的术侧睾丸体积明显小于下降侧、但明显大于未治疗组的隐睾侧;单侧隐睾固定术及切除术组的FSH 明显高于正常组、但切除术组的FSH 又明显高于固定术组。③手术年龄

<5岁组的阴毛发育程度、阴茎长度和周径、术侧睾丸体积和T 均明显大于≥5岁组;后者的FSH 明显高于前者。

④高位型的术侧睾丸体积明显降低,FSH 明显升高。睾丸体积与FSH 呈负相关关系。　结论:隐睾间质细胞功能损伤程度较轻,单侧隐睾术后青春期性征发育可表现为正常,早期手术可防止隐睾和对侧正常下降睾丸生精功能的损害。

关键词:隐睾;睾丸;隐睾固定术;儿童;性发育;青春期

中图分类号:R697+.22;R726.9 文献标识码:A 文章编号:100923591(2004)0720503203①

Sexual Development in Adolescents after Surgical Treatment for Cryptorchidism

Ding Degang ,Li Qizhong ,Fan X iaoling ,Du T ao

Department o f Urology ,the People ’s Hospital o f Henan Province ,Zhengzhou ,Henan 450003,China (Ding DG ,Li QZ ,Fan XL ,Du T )

Correspondence to :Ding Degang ,E 2mail :dingdeg @

Abstract :　Objective :T o investigate the sexual development in adolescents after surgical treatment for undescended testes.　Methods :One hundred and eighty 2four adolescents underg oing surgery for cryptorchidism before the age of 10years ,22cases received no surgical manage 2ment for unilateral undescended testes ,and 25normal controls were studied.The pubic stage ,the natural length and girth of the penis ,the v olume of the testis ,serum luteinizing horm one (LH ),follicle 2stimulating horm one (FSH )and testosterone (T )were examined to find out the effect of age ,the location of the testis and operative procedures on prognosis.　Results :The pubic stage ,the length and girth of the penis ,the v olume of the testis and T decreased ,but FSH and LH increased significantly in 18adolescents who had underg one bilateral orchiopexy.The v olume of the unilaterally undescended testis was significantly smaller than that of the normally descended contralateral g onad in 152ado 2lescents who had underg one unilateral orchiopexy.FSH was significantly higher in the adolescents surgically treated for unilateral cryp 2torchidism.Those treated by unilateral orchiectomy presented significantly higher levels of FSH than those by unilateral orchiopexy.The pubic stage ,the length and girth of the penis ,the v olume of the testis and T were significantly higher ,but FSH lower in the adolescents treated be 2fore the age of 5years than at the age of 5or older.The decrease in testicular v olume was significantly greater in adolescents with intra 2abdomi 2nal testes.S ignificant negative correlation was found between FSH and testicular v olume.　Conclusion :Leydig cell function seems relatively

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305・①收稿日期:2004204201;修回日期:2004205210

作者简介:丁德刚(19652),男,河南固始县人,副主任医师,硕士,从事泌尿外科专业。通讯作者:丁德刚,E 2mail :dingdeg @