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| References
- Vasectomy |
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2.
Fisch H, Laor E, Reid RE, Tolia BM, Freed SZ. Gonadal dysfunction
after testicular torsion: luteinizing hormone and follicle-stimulating
hormone response to gonadotropin releasing hormone. J.Urol.
1988;139:961-4.
Abstract:
We studied 14 postpubertal patients at an average of 33 months
after treatment for testicular torsion. Of these patients
11 had been treated by detorsion and 3 by orchiectomy. Five
normal male volunteers of the approximate age of the study
group served as controls. The patients treated by detorsion
were subdivided into 3 groups based on the degree of atrophy
of the detorsed testicle: group 1--no testicular atrophy (5),
group 2--25 per cent testicular atrophy (2) and group 3--greater
than 90 per cent testicular atrophy (4). Mean duration of
torsion was greatest in the orchiectomy group (161 hours)
compared to 6, 16 and 29 hours for groups 1, 2 and 3, respectively.
The serum luteinizing hormone and follicle-stimulating hormone
response to an intravenous bolus of 100 mcg. synthetic gonadotropin
releasing hormone was measured in all patients. All groups
had a greater mean follicle-stimulating hormone response to
gonadotropin releasing hormone stimulation than controls (p
less than 0.05). Patients who underwent orchiectomy had the
greatest follicle-stimulating hormone response to gonadotropin
releasing hormone stimulation. Mean luteinizing hormone response
to gonadotropin releasing hormone stimulation was normal in
patients without atrophy (group 1) but it was greater than
controls in patients who had atrophy (groups 2 and 3) or who
underwent orchiectomy (p less than 0.05). Several conclusions
could be made from our study. All patient groups treated for
torsion had evidence of testicular dysfunction. Patients who
underwent orchiectomy displayed more testicular dysfunction
than patients who had atrophy after detorsion. Testicular
dysfunction after torsion is more likely to involve spermatogenic
before Leydig cell function
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