Tek Taraflı İnmemiş Testisi olan İnfantlarda Orşiopeksi Sonrası Serum AMH Seviyelerinin Değerlendirilmesi

Year 2022, Volume: 44 Issue: 4, 569 - 575, 19.07.2022

Murat Topcuoğlu , Veysel Nijat Baş

https://doi.org/10.20515/otd.1029923

Abstract

Serum antimüllerian hormon (AMH) değeri postnatal dönemde 1 yaşa kadar stabil seyreder. Çalışmamızda tek taraflı kriptorşidizm nedeniyle orşiopeksi uygulanan yaşları 3-12 ay olan çocuklarda preoperatif dönemde serum AMH değerleri belirlendi ve postoperatif dönem serum AMH seviyesinde ki değişim incelendi. Çalışma popülasyonu, tek taraflı testisleri palpe edilen ve orşiopeksi uygulanan bir yaş altı 77 kriptorşid çocuktan oluşuyordu. İnmemiş testis tanısı takiben tüm hastalara inguinal orşiopeksi yapıldı. Orşiopeksi öncesi serum AMH seviyeleri ve testis boyutları belirlendi ve orşiopeksi sonrası altıncı ayda AMH seviyeleri ve testis boyutları karşılaştırıldı. Ameliyat sonrası altıncı ay kontrol döneminde ölçülen serum AMH değerleri ameliyat öncesi ölçülen serum AMH değerlerine göre anlamlı yüksek bulundu. Ameliyat sonrası yapılan fizik muayenede bütün testisler skrotumda izlendi. Ameliyat öncesi ve sonrası dönemde orşiopeksi yapılan testis boyutlarında farklılık izlenmedi. AMH, iyi bilinen bir sertoli hücre belirteci olarak gonadal fonksiyonu yansıtabilir. İnfantil mini-puberte olarak adlandırılan dönemi takiben diğer gonadal hormonların aksine serum AMH serumda stabil seyreder. AMH, özellikle bu dönemde testis fonksiyonlarını göstermede diğer serum belirteçlerine göre daha avantajlıdır. Çalışmamızda orşiopeksi sonrası serum AMH seviyesinde anlamlı artış izlendi. Özellikle doğum sonrası ilk yılda testis fonksiyonlarının bir göstergesi olarak orşiopeksi öncesi ve sonrası AMH düzeylerinin karşılaştırılması tedavinin etkinliğini belirlemede de faydalı olabilir.

Keywords

Antimüllerian hormon, Orşiopeksi, İnfertilite

Supporting Institution

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Evaluation Serum AMH Levels After Orchiopexy in Infants with Unilateral Undescended Testis

Abstract

In boys, serum anti-Müllerian hormone (AMH) reflects Sertoli cell function, seminiferous tubular integrity and testicular function. Serum AMH value remains stable until one year of age in the postnatal period. In our study, preoperative and postoperative serum AMH values were compared in infants between age of 3-12 months who underwent orchiopexy due to unilateral cryptorchidism. The study population consisted of 77 cryptorchid children under one year of age who had unilateral palpabl testis and underwent orchiopexy. Following the diagnosis of undescended testis, all patients underwent inguinal orchiopexy. Serum AMH levels and testicular size were evaluated before the orchiopexy, and AMH levels and testicular size were compared at the sixth month following orchiopexy. Serum AMH values measured in the postoperative sixth month control period were significantly higher than preoperative serum AMH values. All testicles were examined in the scrotum in the postoperative period. There was no difference in size of testes that underwent orchiopexy before and after surgery. AMH may reflect gonadal function as it is a well-known Sertoli cell marker. Unlike the other gonadal hormones, AMH remains stable in the serum following the period called infantile mini-puberty. Particulary in this period AMH is more advantageous than other serum markers in demonstrating testicular functions. In our study, a significant increase in serum AMH level was observed after orchiopexy. As an indicator of testicular function, especially in the first year of postnatal period, comparing AMH levels before and after orchiopexy may also be useful in determining the effectiveness of treatment.

Keywords

Antimullerian hormone, Orchiopexy, İnfertility

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