Gonadal function and fertility outcomes after orchiopexy versus orchiectomy for testicular torsion: A systematic review and meta-analysis.
Aya M Nasr, Ali Zamlout, Hamzah M Alghzawi et al.
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In 30 seconds
This systematic review and meta-analysis evaluated hormonal profiles and semen parameters in 538 patients treated with orchiopexy versus orchiectomy for testicular torsion. Orchiectomy led to significant increases in FSH (SMD: 1.63, P < 0.0001) and LH (SMD: 1.31, P < 0.0001), while testosterone and inhibin-B levels were similar between groups. Additionally, orchiectomy resulted in a significant reduction in sperm concentration (MD: -18 million/mL, P = 0.01).
Key findings
- Orchiectomy significantly increased FSH levels (SMD: 1.63, P < 0.0001) compared to orchiopexy.
- Orchiectomy also significantly increased LH levels (SMD: 1.31, P < 0.0001).
- Sperm concentration was significantly reduced by orchiectomy (MD: -18 million/mL, P = 0.01).
- The pooled rate for ipsilateral atrophy after orchiopexy was 38%, influenced by ischemia duration.
Why it matters
Understanding the impact of surgical options on hormonal and fertility outcomes is crucial for clinicians managing testicular torsion. This study highlights the potential long-term implications of orchiectomy versus orchiopexy on male reproductive health.