Academic Journal
Gonadal function and fertility outcomes after orchiopexy versus orchiectomy for testicular torsion: A systematic review and meta-analysis.
| Τίτλος: | Gonadal function and fertility outcomes after orchiopexy versus orchiectomy for testicular torsion: A systematic review and meta-analysis. |
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| Συγγραφείς: | Nasr AM; Department of Urology, Alexandria Main University Hospital, Alexandria, Egypt. Electronic address: aya.nasr1496@alexmed.edu.eg., Zamlout A; Department of Pediatric Surgery. Latakia University, Latakia, Syria., Alghzawi HM; School of Nursing, Tennessee State University, Nashville, Tennessee, USA., Youssef YA; Faculty of Medicine, Suez Canal University, Ismailia, Egypt., Altell AN; Alexandria Faculty of Medicine, Alexandria, Egypt., Abdullah I; Al-Azhar University of Medicine, Cairo, Egypt. |
| Πηγή: | Journal of pediatric surgery [J Pediatr Surg] 2026 Oct; Vol. 61 (10), pp. 163348. Date of Electronic Publication: 2026 Aug 04. |
| Τύπος έκδοσης: | Comparative Study; Journal Article; Meta-Analysis; Systematic Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: Philadelphia, PA : Saunders Original Publication: New York. |
| Ιατρικοί όροι (MeSH): | Spermatic Cord Torsion*/surgery , Spermatic Cord Torsion*/blood , Fertility* , Orchiectomy* , Orchiopexy* , Testis*, Follicle Stimulating Hormone/blood ; Inhibins/blood ; Luteinizing Hormone/blood ; Testosterone/blood ; Humans ; Male ; Semen Analysis ; Treatment Outcome |
| Περίληψη: | Purpose: To review the early and late changes in hormonal profiles, semen parameters, and clinical outcomes in patients treated with orchiopexy versus orchiectomy for testicular torsion. Methods: A systematic search was conducted across MEDLINE, Scopus, Web of Science, Cochrane Library, and other databases, following PRISMA guidelines. Primary Outcomes: FSH, LH, testosterone, inhibin-B, and semen parameters. Quality was assessed using the Newcastle-Ottawa Scale. Certainty of evidence was evaluated using the GRADE framework. Statistical analysis was performed using the random-effects model. Results: Eleven studies involving 538 participants (197 orchiectomy, 341 orchiopexy) were included. Orchiectomy was associated with a significant increase in FSH (SMD: 1.63, P < 0.0001) and LH (SMD: 1.31, P < 0.0001) compared to orchiopexy. However, testosterone (MD: 0.31 ng/mL; P = 0.4) and inhibin-B (SMD: -0.14; P = 0.87) levels were comparable between groups. Regarding semen parameters, orchiectomy resulted in a significant reduction in sperm concentration (MD: -18 million/mL, P = 0.01). No significant differences were found in sperm count (MD: 13.9 million; P = 0.43), normal morphology (MD: 4.97%; P = 0.12), or total motility (MD: 4.05%; P = 0.49). The pooled rate for ipsilateral atrophy following orchiopexy was 38%, which likely depends on ischemia duration. Conclusion: Surgical choice in testicular torsion does not significantly affect the overall hormonal balance or most semen parameters due to compensatory mechanisms of the hypothalamic-pituitary-gonadal axis. Clinical decisions should consider individual case factors, as we lack reliable data on subsequent paternity rates. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Conflicts of interest The authors declare no conflict of interest. |
| Contributed Indexing: | Keywords: Meta-analysis; Orchiectomy; Orchiopexy; Systematic review; Testicular detorsion; Testicular fixation; Testicular salvage; Testicular torsion |
| Substance Nomenclature: | 9002-68-0 (Follicle Stimulating Hormone) 0 (inhibin B) 57285-09-3 (Inhibins) 9002-67-9 (Luteinizing Hormone) 3XMK78S47O (Testosterone) |
| Entry Date(s): | Date Created: 20260803 Date Completed: 20260911 Latest Revision: 20260921 |
| Update Code: | 20260921 |
| DOI: | 10.1016/j.jpedsurg.2026.163348 |
| PMID: | 42546903 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1531-5037 |
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| DOI: | 10.1016/j.jpedsurg.2026.163348 |