Cryptorchidism: Fowler-Stephens procedure or autotransplantation - A new experimental model

Objectives. To investigate the effect of different operative procedures on testicular development in cryptorchidism. Methods. One hundred ten postpubertal Wistar-WU rats were divided into four groups. Group 1 (35 rats) underwent microsurgical autotransplantation of t he right testis with end-to-end anastomosis of the testicular vessels. Grou p 2 (35 rats) underwent the Fowler-Stephens maneuver with intra-abdominal f ixation of the testis. To determine the influence of temperature on testicu lar development, group 3 (35 rats) underwent the Fowler-Stephens maneuver w ith scrotal replacement of the testis. Group 4 (5 rats) was a control group without operative treatment. To assess the early and late changes of testi cular ischemia and reperfusion, groups 1 to 3 were divided into seven subgr oups (5 rats each) with defined postoperative intervals (0.5 hour, 2 hours, 4 hours, 8 hours, 16 hours, 14 days, and 60 days). Testicular development, sperm density, pH value, tissue lactate concentration, and tubular diamete r were the parameters used to determine success or failure. Results. After autotransplantation, testicular development exhibited an atr ophy rate of less than 50% and a significant decrease in groups 2 and 3 aft er 60 days. The sperm density was significantly different between groups 2 and 4 (control). The pH value was significantly different after 2 hours in groups 2 and 3. The tissue lactate concentration revealed no significant di fferences. The tubular diameters were significantly diminished in group 2 a fter 60 days. Conclusions. The smaller atrophy rate of the testes suggests that we succes sfully established a model in the rat to compare the operative outcome afte r autotransplantation and the Fowler-Stephens procedure in cryptorchidism. The significant difference in the tubular diameters for the intra-abdominal ly placed testes might be caused by the exposure of the testis to a higher temperature. UROLOGY 56: 886-890, 2000. (C) 2000, Elsevier Science Inc.