Long-term outcomes of erectile function in adult orchidopexy patients

ObjectiveCryptorchidism affects up to 6% of full-term male infants, and orchidopexy has been shown to reduce impaired spermatogenesis and malignant risks significantly. However, the relationship between orchidopexy and sexual function has not been investigated. Therefore, this study aimed to evaluate sexual function outcomes in adult patients who underwent orchidopexy for unilateral undescended testis in childhood.MethodsTotally, 58 adult patients who underwent unilateral orchidopexy in childhood were enrolled in the study. Erectile dysfunction (ED) was assessed by the International Index of Erectile Function (IIEF)-15 questionnaire. All participants underwent serum (testosterone and follicular stimulating hormone levels) measurement and semen analysis. Paternity rates were evaluated to assess the patient's fertility. Additionally, anxiety, depression, and stress were measured by the self-rating anxiety scale, self-rating depression scale, and visual analogue scale, respectively.ResultsThere was no statistically significant difference between IIEF-15 scores (intercourse satisfaction, orgasmic function, sexual desire, or overall satisfaction) comparing the cryptorchidism group with the control group;however, the ED was significantly higher in the cryptorchidism patients (p=0.000). At the median follow-up of 16.3 years, 15.5% of our patients complained of moderate to severe ED. Most patients were satisfied with their overall relationship and only 34.5% were not satisfied. Anxiety, depression, and stress were more prevalent in cryptorchidism than in healthy men (anxiety: 72.4% vs. 20.7%;depression: 19.0% vs. 5.2%;stress: 60.3% vs. 10.3%;p˂0.05). Additionally, ED was negatively associated with anxiety, depression, and stress symptoms (r=−0.518, p=0.000;r=−0.448, p=0.000;r=−0.591, p=0.000, respectively). Moreover, ED had a significant correlation with advancing age, psychological factors (anxiety, depression, and stress), infertility, and low levels of testosterone (p˂0.05).ConclusionLow testosterone, infertility, and psychological burden (anxiety, depression, and stress) are used as factors for predicting ED outcomes after orchidopexy for undescended testis to guide physicians to evaluate the efficacy of testosterone replacement and psychological support in their management.

High platelet distribution width can independently predict testicular survival in testicular torsion among patients with steady-state sickle cell anemia

Objective This study aimed to evaluate the predictive value of platelet volume indices(PVI),such as mean platelet volume(MPV),platelet distribution width(PDW),and plateletcrit(PCT),as prognostic indicators of testicular viability in torsion patients with steady-state sickle cell anemia(SCA)who underwent surgical exploration.Methods Forty-eight patients with SCA with testicular torsion and 46 male control subjects were enrolled in the study.All patients underwent scrotal color Doppler ultrasonography before surgery,and PVI(MPV,PDW,and PCT)values were measured in all participants.Symptom duration and testicular volume were also recorded.Results The testicular salvage rate in patients with SCA was 73%after surgery.Analyses showed that MPV,PDW,and PCT values were significantly higher in torsed SCA as compared with controls(p<0.05).Orchiectomy in patients with SCA showed significantly higher MPV,PDW,and PCT values than the orchiopexy group(p<0.05).The MPV values of orchiectomy patients showed a higher significant cut-off of≥11.5 fL,which is higher than in torsed patients without SCA,as an indicator of testis survival.PDW also demonstrated a higher significant cut-off of≥12.7 fL for detorsion outcomes in patients with SCA.Symptom duration of less than 7 hours was also significantly correlated with orchiopexy(p≤0.001).Univariate analysis showed that higher MPV,increased PDW,and symptom duration were indicative of the outcome of testicular detorsion in SCA.Multivariable analysis showed that increased PDW and symptom duration are prognostic parameters for testicular viability in SCA.Conclusion Increased PDW and symptom duration can be used as parameters for predicting testicular detorsion outcomes in patients with steady-state SCA.