83 / 238
83
11–14 APRIL, 2018, HELSINKI, FINLAND
CONCLUSIONS
Revision scrototomy is indicated in all cases, when the testicular volume exceeds 2.25 ml, diagnos-
tic laparoscopy is an optimal starting procedure for patients with the contralateral testicular volume
under 1.04 ml.
14:08–14:11
S9-3 (PP)
TUBULAR FERTILITY INDEX (TFI) IN CORRELATION
WITH TESTIS POSITION, CONSISTENCY, EPIDIDYMAL
ANATOMY AND AGE AT ORCHIDOPEXY IN 237 BOYS
WITH CRYPTORCHIDISM
Katja P. WOLFFENBUTTEL
1
, Ries KRANSE
2
, Hans J.A. STOOP
3
,
Fred VAN DER TOORN
1
, J.W. OOSTERHUIS
3
, Katharina BIERMANN
3
,
Jeroen R. SCHEEPE
1
, Joop VAN DEN HOEK
1
and Leendert H.J. LOOIJENGA
3
1) Erasmus MC - Sophia Children's Hospital, Pediatric Urology, Rotterdam, NETHERLANDS - 2) Netherlands
Comprehensive Cancer Organisation (IKNL), Rotterdam, NETHERLANDS - 3) Erasmus MC, Pathology, Rotterdam,
NETHERLANDS
PURPOSE
Epididymal anomalies in cryptorchidism are common, especially in proximal positioned testes. Aims
of the study were to: 1. classify epididymal anatomy according to a modified scoring system in
8 categories; 2. investigate the percentage of germ cell containing seminiferous tubules, Tubular
Fertility Index (TFI), in a testicular biopsy taken during orchidopexy; 3. compare TFI with recorded
clinical information on testis position, consistency, epididymal anatomy and age at orchidopexy.
MATERIAL AND METHODS
Between 2001 and 2017 testicular histology from 237 patients (263 testes) with cryptorchidism
was available for review; 60 patients (68 testes) with missing data on clinical variables but with
documented TFI and age at surgery were initially excluded. The remaining 177 patients (195 tes-
tes), aged between 5 and 244 months (mean 39 months) were investigated. For statistical analysis
fractional logistic regression analysis was used.
RESULTS
Testis position was abdominal in 20 (11 %), internal ring in 54 (27 %), canalicular in 84 (43 %) and
external ring in 37 (19 %). Testis consistency was normal in 58 (30 %), soft in 59 (30 %) and inter-
mediate in 78 (40 %). Normal epididymal anatomy (category 1 and 2) was seen in only 68 (35 %)
testes. The TFI was >60 % in 50 testes (26 %); 30–60 % in 55 (28 %); < 30 % in 65 (33 %) and
0 (SCO) in 25 (13 %). Fractional logistic regression analysis showed that age at orchidopexy was
the only clinical parameter that significantly predicted the TFI (p 0.00). The obtained model for TFI
was validated in the initially excluded 68 testes because of incomplete data, but documented TFI
and age at surgery.
CONCLUSIONS
Exclusively age at orchidopexy correlated significantly with TFI. TFI decrease with age at surgery
suggests that current guidelines for timing of orchidopexy in boys with undescended testes (be-
tween 6 and 18 months) should be tightened to the age of 6 months or soon afterwards.
14:11–14:20
Discussion