Usefulness and limitation of punched-out orchidometer in testicular volume measurement

Aim: To determine the limitations of a punched-out orchidometer in practical use, we compared with a scrotal ultrasound (USG). Methods: A total of 281 testes from 142 males were examined using both a punched-out orchidometer and a USG. The volume differential between both methods was calculated and expressed as orchidometer/ USG volume (OAJ ratio). Distribution of the O/U ratio was determined and subdivided by clinical or pathological diagnosis. The correlations between the O/U ratio and patient age or orchidometer results were assessed. Results: There was a significant linear relationship between the results of orchidometer and USG (r = 0.94, P < 0.0001). The relationship between the O/U ratio and age or testicular volumes showed significant inverse correlations (r = 0.22, P = 0.0002, r = 0.45, P < 0.0001, respectively). Klinefelter's syndrome, ipsilateral detorted testes and hypogonadotropic hypogonadism comparatively showed a high O/U ratio. No incidental lesion was detected by USG necessitating treatment. Conclusion: The punched-out orchidometer gives estimates that correlated well with the USG measurements and provides enough information for routine andrological evaluation. We should be aware that the orchidometer often overestimates the testicular volume, especially for the patients with small testis or adolescents.

Relationship between testicular volume and testicular function： comparison of the Prader orchidometric and ultrasonographic measurements in patients with infertility

Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testicular function by each method. Methods： Total testicular volume （right plus left testicular volume） was measured in 794 testes in 397 men with infertility （mean age, 35.6 years） using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length x width x height x 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more. Results： Mean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography. Conclusion： Testicular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US. （Asian JAndro12008 Mar; 10： 319-324）

Penile length and somatometric parameters： a study in healthy young Turkish men

The purpose of this study was to determine average penile length and to investigate the relationship between penile length and somatometric parameters in a group of young, healthy Turkish men. A total of 1132 men were included in the study. The age, height and weight of the subjects were recorded. Penile length was measured in both flaccid and stretched states. The correlation between penile length and somatometric parameters was analysed. The mean age of the subjects was 20.3±.0.9 years. The mean penile length in flaccid and stretched states was 9.3± 1.3 and 13.7± 1.6 cm, respectively （P〈0.001）. There was a positive correlation between flaccid and stretched penile length （r=0.800, P〈0.001）. The mean testicular volume was 22.0±2.8 cm3. A weak positive correlation was detected between penile length and mean testicular volume （r=0.143 for flaccid penile length and r=-0. 140 for stretched penile length, P〈0.001 for both）. Similarly, weak positive correlations were found between penile length （both flaccid and stretched） and height, weight and body mass index, respectively （P〈0.001, for all）. These results demonstrate that somatometric parameters are correlated with penile length. We believe that further studies would provide more information about the causal relationship.

Inter/intra investigator variation in orchidometric measurements of testicular volume by ten investigators from five institutions

Aim： To perform quality control studies on testicular volume measurements for a multi-center epidemiological study of male reproductive function. Methods： We constructed a data matrix with a balanced assignment for 2 consecutive days by ten investigators （andrological career： 4-21 years） from five institutions and 12 male volunteers aged 20-26 years. Testicular volume was measured by Prader＇s orchidometer. A skilled technician also performed an ultrasound estimate of testicular volume. Results： A statistically significant inter-investigator variation was found for both testes （P 〈 0.05）. In addition, there was a statistically significant investigator-by-volunteer interaction in testicular volume measurement （P 〈 0.01）. However, there was no statistically significant difference in the two measurements performed on consecutive days for either testis. The testicular volumes for both the right and left testes as estimated by ultrasonography were smaller than results using the orchidometer. However, there was no statistical significance （P 〉 0.05）. The difference in experiences of the investigators did not significantly correlate with accuracy of measurements in either testis. Conclusion： The present study revealed significant differences in the results of estimation of testicular volume among the ten investigators, but intra-investigator variation was not considerable. Improved training and proper standardization of the measurement will be necessary before starting a multi-center study based on an andrological examination.

Testicular volume in infertile versus fertile white-European men: a case-control investigation in the real-life setting

Testicular volume(TV)is considered a good clinical marker of hormonal and spermatogenic function.Accurate reference values for TV measures in infertile and fertile men are lacking.We aimed to assess references values for TV in white-European infertile men and fertile controls.We analyzed clinical and laboratory data from 1940(95.0%)infertile men and 102(5.0%)fertile controls.Groups were matched by age using propensity score weighting.TV was assessed using a Prader orchidometer(PO).Circulating hormones and semen parameters were investigated in every male.Descriptive statistics,Spearman's correlation,and logistic regression models tested potential associations between PO-estimated TV values and clinical variables.Receiver operating characteristic(ROC)curves were used to find TV value cutoffs for oligoasthenoteratozoospermia(OAT)and nonobstructive azoospermia(NOA)status in infertile men.The median testicular volume was smaller in infertile than that of fertile men(15.0 ml vs 22.5 ml;P<0.001).TV positively correlated with total testosterone,sperm concentration,and progressive sperm motility(all P≤0.001)in infertile men.At multivariable logistic regression analysis,infertile status(P<0.001)and the presence of left varicocele(P<0.001)were associated with TV<15 ml.Testicular volume thresholds of 15 ml and 12 ml had a good predictive ability for detecting OAT and NOA status,respectively.In conclusion,infertile men have smaller testicular volume than fertile controls.TV positively correlated with total testosterone,sperm concentration,and progressive motility in infertile men,which was not the case in the age-matched fertile counterparts.