Unilateral testicular injury from external trauma

Evaluation of semen quality and endocrine parameters

William W. Lin, Edward Kim, Emilio T. Quesada, Larry I. Lipshultz, Michael Coburn

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Purpose: Because few studies have described the impact of unilateral testicular trauma on fertility parameters, we review the experience at the Ben Taub General Hospital during a 16-year period. Semen and endocrine profiles were analyzed to evaluate the influence on the outcomes of orchiectomy versus testicular salvage. Materials and Methods: From 1979 to 1995, 67 patients were identified who sustained unilateral testicular trauma. Of these patients 12 were located and 10 agreed to be evaluated. Injuries included gunshot wounds, stab wounds and blunt trauma, and treatment consisted of unilateral orchiectomy or testicular repair. The study protocol comprised a history and physical examination, routine semen analysis, determination of semen and serum antisperm antibody titers (Immunobead* assay) and a modified gonadotropin stimulation test. Results were compared with a group of semen donors with proved fertility. Results: In the 7 patients who underwent unilateral orchiectomy mean sperm density was normal but significantly decreased compared with that of the fertile controls (81.6 versus 132.6 x 106/ml., p = 0.04). Sperm motility was not significantly affected. Baseline follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and post-stimulation LH were significantly increased in this group compared with controls (p <0.01). In the group that underwent testicular repair sperm density, motility, and baseline and post-stimulation FSH and LH levels were not significantly different from controls. In all patients in both groups testosterone levels and contralateral testicular size were normal. Only I patient in the repair group had an elevated serum and semen antisperm titer. Conclusions: While the testicular salvage group had no significant seminal or endocrine abnormality, the orchiectomy group had a significant decrease in sperm density and elevation of baseline FSH and LH. These preliminary data suggest that testicular salvage is more protective of overall testicular function than orchiectomy.

Original languageEnglish (US)
Pages (from-to)841-843
Number of pages3
JournalJournal of Urology
Volume159
Issue number3
DOIs
StatePublished - Jan 1 1998
Externally publishedYes

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Semen Analysis
Orchiectomy
Luteinizing Hormone
Follicle Stimulating Hormone
Semen
Wounds and Injuries
Sperm Motility
Fertility
Spermatozoa
Stab Wounds
Gunshot Wounds
Serum
Gonadotropins
General Hospitals
Physical Examination
Testosterone
History
Tissue Donors
Antibodies

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Unilateral testicular injury from external trauma : Evaluation of semen quality and endocrine parameters. / Lin, William W.; Kim, Edward; Quesada, Emilio T.; Lipshultz, Larry I.; Coburn, Michael.

In: Journal of Urology, Vol. 159, No. 3, 01.01.1998, p. 841-843.

Research output: Contribution to journalArticle

Lin, William W. ; Kim, Edward ; Quesada, Emilio T. ; Lipshultz, Larry I. ; Coburn, Michael. / Unilateral testicular injury from external trauma : Evaluation of semen quality and endocrine parameters. In: Journal of Urology. 1998 ; Vol. 159, No. 3. pp. 841-843.
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