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Hodenhochstand und Infertilität unter besonderer Berücksichtigung der interdisziplinären Leitlinie

Cryptorchidism and infertility from the perspective of interdisciplinary guidelines

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Zusammenfassung

Hodenhochstand ist die häufigste genitale Fehlbildung bei Jungen. Frühgeborene Jungen sind bis zu einem Drittel vom Maldescensus testis betroffen, bei termingerecht geborenen Knaben leiden etwa 2–5% an mindestens einem nicht deszendierten Hoden.

Infolge einer kurzfristigen endogenen Testosteronsekretion nach der Geburt reduziert sich die Inzidenz nach 3 Monaten auf 1–2%. Eine abwartende Haltung („watchful waiting“) nach 6 Monaten ist nach der Studienlage nicht indiziert, da es hiernach nur sehr selten zu einem spontanen Deszensus kommt. Obwohl die Auswirkung des Hodenhochstands auf die testikuläre Entwicklung und Fertilität umfassend untersucht worden ist, bleibt als einzige Tatsache die Gewissheit, dass unbehandelte Männer mit einem bilateralen Hodenhochstand in ca. 90% der Fälle eine Azoospermie entwickeln. Die übrigen Szenarien des Hodenhochstands (unilateral, ektop, inguinal, Gleithoden, behandelt oder nicht behandelt) weisen eine unvorhersagbare Fertilität und Wahrscheinlichkeit einer Vaterschaft aus.

Abstract

Cryptorchidism is the most common genital disorder in boys. Early-born boys are affected in up to one third of the cases, while about 2–5% of full-term newborns suffer from at least one undescended testicle.

As a result of short-term endogenous testosterone secretion after birth the prevalence decreases to 1–2% after 3 months. According to most studies, watchful waiting after 6 months is not justified because after this time spontaneous testicular descent only very rarely occurs. Even though the effects of testicular development and fertility in undescended testis have been extensively examined, the only fact that remains certain is that approximately 90% of untreated men with bilateral cryptorchidism develop azoospermia. The remaining scenarios of cryptorchidism (unilateral, ectopic, inguinal, treated or not treated) exhibit unpredictable fertility and likelihood of fatherhood.

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Authors and Affiliations

  1. Urologische Gemeinschaftspraxis Remscheid, Kooperationspraxis der Klinik für Urologie und Kinderurologie, Helios Klinikum Wuppertal, Universität Witten/Herdecke, Fastenrathstraße 1, 42853, Remscheid, Deutschland

    M.J. Mathers F.E.B.U.

  2. Klinik für Urologie und Kinderurologie, Helios Klinikum Wuppertal, Universität Witten/Herdecke, Witten/Herdecke, Deutschland

    S. Degener & S. Roth

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  1. M.J. Mathers F.E.B.U.
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  3. S. Roth
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Correspondence to M.J. Mathers F.E.B.U..

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Mathers, M., Degener, S. & Roth, S. Hodenhochstand und Infertilität unter besonderer Berücksichtigung der interdisziplinären Leitlinie. Urologe 50, 20–25 (2011). https://doi.org/10.1007/s00120-010-2438-x

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