隐睾术后远期生育力随访研究  

Long term follow-up study of fertility after orchidopexy in children with cryptorchidism

作　　者：吕小梅[1] 吴荣德[1] 刘伟[1] 崔明宇[1] 郭宗远[1] 张丽娟[1] 

机构地区：[1]山东大学附属省立医院小儿泌尿外科,济南250012

出　　处：《中华小儿外科杂志》2012年第3期176-178,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的通过分析生育率及精液来评价单双侧隐睾患者睾丸固定术后远期生育力。方法随访1981年10月至1997年11月期间做过隐睾手术的患者342例，分析已婚者的生育及不育治疗情况和未婚者的精液质量，来评价患者生育力。结果共有49例患者获得完整资料，随访率为14．3％，其中单侧33例，双侧16例。已婚者中单侧隐睾患者生育率为92．9％，双侧为37．5％，生育者怀孕时间（从计划怀孕至成功怀孕的时间）单侧隐睾平均为3个月，双侧为6．3个月；不育者中有4例经药物治疗后精液正常，3例已经生育。未婚者中单侧隐睾患者的精液正常率为84．2%，双侧为25．0％。双侧隐睾精液异常者中腹腔内型隐睾占66．7%。结论单侧隐睾患者术后远期生育力接近正常人，而双侧隐睾生育率及精液正常者远低于单侧；双侧隐睾患者怀孕时间大于单侧；部分不育患者治疗后可以生育。双侧腹腔内型隐睾更易致精液异常。Objective To access the long term fertility after orchidopexy in children with unilat- eral or bilateral cryptorchidism through analysis of fertility rate and semen evaluation. Methods Be- tween October 1981 and November 1997, totally 342 cases of cryptorchidism underwent orchidopexy procedure in our centre, and the follow up study was conducted. The procreation status among mar- ried patients and semen analysis for unmarried patients were targeted to investigate their fertilities. The clinical information was collected through mail, telephone and subsequent visit. Results Complete clinical information could be collected in 49 （14. 3%） of all populations, in which unilateral cryp- torchidism was found in 33 cases and bilateral ones in 16 cases. Among married patients the fertility rate was 92. 9% in unilateral cases, while 37. 5% in bilateral ones. For those patients whose wives gave birth, the mean time of planned pregnancy was 3 months in unilateral cases, and 6. 3 months in bilateral ones. While for infertility patients, semen from 4 cases was already normal after drug treat- ment, in which 3 patientg wives already gave birth. Among unmarried populations, normal rate of se- men in unilateral cryptorchidism was 84. 2% and 25% in bilateral ones. The abdominal cryptorchid could be found in 66. 7 percent of in bilateral cryptorchidism with abnormal semen. Conclusions Long term fertility in children with unilateral cryptorchidism is similar with the normal ones, while fertility rate and normal semen in bilateral ones are significantly lower than unilateral ones after sur- gery. Compared with the unilateral ones, the planned pregnancy time for bilateral ones are long. Part of infertility has fertility potential after drug treatment. The semen in bilateral abdominal eryptorchid is more likely to be abnormal.

关 键 词：隐睾 睾丸固定术 精液分析 生育力 

分 类 号：R726.9[医药卫生—儿科]