对不同年龄段男孩未降睾丸生育成分的组织病理学研究

MM Rahman, Zahid Hossain Akmz, Dr. Md. Mizanur Rahman, Dr. A K M Zahid Hossain
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摘要

背景:无睾丸是最常见的男性发育异常,单侧和双侧无睾丸均可导致不育。在该研究中,我们根据患者的年龄评估了未闭睾丸的组织学参数,并建议了睾丸穹隆成形术的最佳时机。目的评估未降睾丸的组织学参数,并确定睾丸楔切术的最佳时机。方法和材料:这项横断面研究纳入了 BSMMU 儿外科的 30 名睾丸下降患者。在询问相关病史后,将所有研究对象的检查结果和调查报告记录在预先测试的数据收集表中。然后,在睾丸切除术中从选定的睾丸中采集活检标本,并分析各项参数,包括平均睾丸管直径(MTD)、平均睾丸管生育指数(MTFI)、生殖细胞计数(GCC)、Sertoli细胞指数(SCI)和间质纤维化指数(IFI):2岁儿童的平均肾小管生育力指数(MTFI)和生殖细胞计数(GCC)高于5岁组。大于 5 岁组的 IFI 明显高于其他年龄组(P < 0.05)。其他参数,如睾丸体积、MTD 和 SCI,在所研究的年龄组之间没有明显的统计学差异。结论这项研究表明,6 个月至 1 岁的婴儿睾丸小管中存在较多的生殖细胞。一岁后,主要的生殖细胞参数会持续恶化,因此我们建议在 6 个月至 1 岁之间但不迟于 2 岁进行睾丸切除术,以保留未来的生育能力:26-31
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Histopathological study of the fertility components of undescended testes in boys of different age group
Background: Undescended testes presents the most common male developmental abnormalities, with infertility frequently observed in unilateral as well as bilateral forms. In that study, we evaluated the histological parameters of Undescended testes based on patient’s age and we recommended for the optimal timing for orchiopexy. Objective: To evaluate the histological parameters of undescended testis and determine the optimal timing for orchiopexy. Methods and Materials: This cross-sectional study included 30 patients with undescended testis(es) in the department of paediatric surgery, BSMMU. After taking relevant history, examination findings and investigation reports of all the study subjects were recorded in the pretested data collection sheet. Then biopsy specimens were collected from the selected testes during orchiopexy and analyzed the parameters including mean tubular diameter (MTD), mean tubular fertility index (MTFI) germ cell count (GCC), Sertoli cell index (SCI) and interstitial fibrosis index (IFI) Results: The MTFI and GCC in children <1 years of age were significantly higher than those of other older age group. (P= 0.011 & P= 0.003) The MTFI, GCC and IFI were significantly better in patients <2 years of age when compared to those of > 2years. IFI in the > 5-years group was significantly higher than those of any of the other younger age groups (P < 0.05). Other parameters such as testicular volume, MTD and SCI showed no statistically significant difference between the age groups studied. Conclusions: This study revealed that higher number of germ cells exists in the tubules between 6 months and 1 year. After first year of life, the major germ cell parameters deteriorate continuously, thus we recommended that orchipexy should be performed, between 6 months and 1 year but no later than 2 years for preserving future fertility. Journal of Paediatric Surgeons of Bangladesh (2019) Vol.10 (1 & 2): 26-31
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