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. 2022 Jul;130 Suppl 143(Suppl 143):1-58.
doi: 10.1111/apm.13247.

Clinical aspects of histological and hormonal parameters in boys with cryptorchidism: Thesis for PhD degree

Simone Engmann Hildorf  1
Affiliations

Clinical aspects of histological and hormonal parameters in boys with cryptorchidism: Thesis for PhD degree

Simone Engmann Hildorf. APMIS. 2022 Jul.
No abstract available

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Figures

Fig. 1
Fig. 1
Germ cell maturation. Schematic illustration of the postnatal germ cell maturational steps through migration, morphological characteristics, and expression profiles. Histologically, the seminiferous tubules in the infant boy does not have a lumen and are filled with Sertoli cells and germ cells. (A) HE‐staining of testis biopsy from an infant boy with cryptorchidism illustrating the typical morphological characteristics of spermatogonia, arrow (B) in PLAP‐staining, and (C, D) ad spermatogonia, arrowhead.
Fig. 2
Fig. 2
The hypothalamic–pituitary–gonadal axis. Schematic presentation of the function and regulation of the male hypothalamic–pituitary‐gonadal axis. (A) the concentrations of reproductive axis hormones during minipuberty.
Fig. 3
Fig. 3
(A) The normal descent of the testes. Illustration of key elements during the transabdominal phase, which is dependent on insulin‐like 3 hormone (INSL3). The solid lines relate to the most evident and essential hormonal signals, whereas the dotted lines represent more uncertain and probably weaker signals. (B) The normal descent of the testes. Illustration of the key elements during the androgen‐dependent inguinoscrotal phase.
Fig. 4
Fig. 4
The gubernaculum. What the gubernaculum can look like at orchidopexy in an 11‐months old patient with right‐sided cryptorchidism. In this patient, the gubernaculum is a bulky and fibrous structure connected to the caudal pole of both the testis and epididymis, which is covered on all sides by a peritoneum except the posterior where the vessels and ductus deferens pass. (published after consent received from the boy's parents).
Fig. 5
Fig. 5
Cryptorchidism. Two 10‐months old boys with unilateral congenital cryptorchidism, (A) left‐sided and (B) right‐sided and non‐palpable, where the testis was located within the inguinal canal verified by laparoscopy. (Published after consent was received from the boy's parents.)
Fig. 6
Fig. 6
Prevalence of cryptorchidism. The reported prevalence (%) of cryptorchidism in relation to the age of the boys. Source from Thorup et al. [5].
Fig. 7
Fig. 7
The different locations of a cryptorchid testis. Illustration of normal pathway of testicular descensus (black) and maldescensus leading to cryptorchidism (red). Cryptorchid testes are classified on the basis of their position along the pathway of descent; high or low intraabdominal, inguinal including close to the internal or external annular ring, suprascrotal, or ectopic involving an abnormal location outside the normal pathway.
Fig. 8
Fig. 8
The fertility potential as a tool to classify cryptorchidism. A hypothesis from our group—that the spectrum of cryptorchidism might comprise different patterns in the fertility potential at the time of surgery.
Fig. 9
Fig. 9
Summary of patients included. Overview of boys with cryptorchidism included in Papers I–V. The arrows indicate that some boys were included in two studies.
Fig. 10
Fig. 10
Testicular biopsies. A testicular biopsy was obtained at the Department of Pediatric Surgery, Rigshospitalet. (A) A longitudinal incision in the tunica albuginea, (B) Excision with a scissor to obtain a biopsy sample, (C, D) A testicular biopsy of approximately 2–3 mm3. (Published after consent was received from the boy's parents.)
Fig. 11
Fig. 11
Normal lower range of G/T. Reference lower ranges of G/T in the studies included in this thesis based on normal materials [44, 56, 60, 61].
Fig. 12
Fig. 12
Overview of Paper III. A schematic overview of the results of the 208 boys with bilateral cryptorchidism stratified into three groups based on the findings at surgery.
Fig. 13
Fig. 13
Discussion—how to assess hormones when evaluating the effect of orchidopexy?. An overview of how clinicians could use histological and hormonal parameters to clarify the use of adjuvant hormonal treatment.
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References

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