思春期および成人停留睾丸患者の睾丸機能 --下降側と停留側との比較--

Abstract

思春期および成人停留睾丸患者について下降側と停留側を比較すると精子形成能のみならずandrogen生成に関与する酵素群の活性も停留側では低下が認められた.停留側睾丸は副睾丸の形態異常もしくは睾丸血管系の短縮など胎生期での睾丸機能不全を思わせる異常を合併しており精子形成能およびandrogen生成に関与する酵素群活性の低下は内在する睾丸機能不全にさらに温熱障害という二次的要因が加わったためと考えられた.下降側睾丸も本症患者においてはJohnsen's scoreや血中hormone levelより睾丸機能不全を内在している可能性がある

Ten pubescent or adult patients with unilateral cryptorchidism were examined for abnormal findings of the epididymis and of the gabernaculum Hunteri in the undescended sides at orchidopexy. Histological examinations and the experiments for enzyme activities relating to androgen biosynthesis in vitro were also performed using biopsied specimen obtained from both sides at the operation and the results for the descended and the undescended sides were compared. The results are as follows. The undescended sides were accompanied by either morphological abnormalities of epididymis or shortening of the testicular blood vessel. Ectopy of the gaberunaculum was observed in the undescended side. Both Johnsen's mean score and enzyme activities relating to androgen biosynthesis in the undescended sides were lowered compared to those of the descended sides. One case showed an elevated FSH level in the blood associated with a low Johnsen's score in the descended side and in other case the LH level in the blood was elevated. These results indicate that not only the spermatogenesis but androgen biosynthesis in the undersended sides are lowered compared to the descended sides. The results, moreover, suggest the possibility of the involvement of congenital testicular disorder even in the descended side of the cryptorchidism.