【7/12更新】2022年4月1日からのCiNii ArticlesのCiNii Researchへの統合について

停留精巣における精巣上体付着異常の臨床的検討

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  • A Clinical Study on Epididymal Abnormalities Associated with Undescended Testis

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Purpose: Among the epididymal abnormalities observed at a relatively high rate in patients with undescended testis, we focused on the state of adhesion between the testis and the epididymis and evaluated the clinical significance of this condition. We devised a new classification based on the location of the abnormal adhesions and attempted to assess abnormal adhesion on the basis of this new classification method. Subjects and methods: The subjects of the study were patients with a total of 264 undescended testis and 352 testes. The items investigated included morphologiocal observation of the undescended site and the site of adhesion of the epididymis, age at operation, postoperative volume of testis, and seminal findings in patients who consented to a follow-up observation after puberty (n=29). The new classification for abnormal adhesion employed 5 grades based on our hypothesis that the severity of adhesion would be likely to in crease with the departure of the caput epididymidis. Results: Abnormal adhesion of the epididymis was observed in 53.7% of the testes. The higher the undescended site, the higher the incidence of abnormal adhesion was found to be. There was a significant correlation between the grade of retention and the grade of abnormal adhesion by the new classification. A comparison of the postoperative testis volume with the grade of retention showed a significantly lower value for the high-grade group. A tendency was also observed for the group with severe abnormal adhesion to show a lower value for the postoperative testis volume. When the undescended site was scored and compared with the seminal findings, a high score was seen in the group with a poor sperm concentration. Conclusions: The high incidence of abnormal epididymal adhesion in patients with a high grade of retention and the close correction between the grade of retention and the grade of abnormal adhesion suggested the clinical importance of abnormal epididymal adhesion in patients with undescended testes. Furthermore, the existence of a correlation between the grade of abnormal adhesion and the postoperative volume of the testis is considered to be an important finding with significant implications for future investigations of issues relating to abnormal epididymal adhesion and fertility.

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