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Abstract

Volume 11, Issue 6 (November 2009) 11, 741–745; 10.1038/aja.2009.54

Effect of hydrocele on appendix testis in children

Tamás Józsa1,2, Andrea Telek3, Balázs Kutasy1, Mátyás Benyó2, Gábor Csanádi2, Ilona Kovács4, György Balla1, Tibor Flaskó2, László Csernoch3 and Csongor Kiss1

1 Department of Pediatrics, Medical and Health Science Center, University of Debrecen, Debrecen 4032, Hungary
2 Department of Urology, Medical and Health Science Center, University of Debrecen, Debrecen 4032, Hungary
3 Department of Physiology, Medical and Health Science Center, University of Debrecen, Debrecen 4032, Hungary
4 Department of Pathology, Kenézy Gyula County Hospital, Debrecen 4032, Hungary

Correspondence: Dr Tamás Józsa,jozsa_tamas@freemail.hu

Received 17 March 2009; Revised 21 April 2009; Accepted 6 August 2009; Published online 28 September 2009.

Abstract

The purpose of this study was to investigate the effects of an elevated hydrostatic pressure of hydrocele on the structural integrity and steroid receptor expression pattern of the appendix testis in children. Twenty-six testicular appendages were obtained from boys (aged between 13 and 79 months, mean 40 months) who underwent surgical exploration because of hydrocele or congenital inguinal hernia. The tissue sections of testicular appendages were stained with hematoxylin-eosin. Immunohistochemistry and immunofluorescence laser microscopy were performed using monoclonal mouse anti-human receptors against androgen and estrogen receptors. Patients were divided into three groups: group A (n = 8) represented patients with groin hernia without hydrocele, who served as control group; group B (n = 7) represented patients with communicating hydrocele; and group C (n = 11) represented patients with noncommunicating hydrocele. The tissue sections of appendix testis expressed both androgen and estrogen receptors in all patients in groups A and B, and epithelial destruction was not present. The presence of androgen receptor (two of 11, P < 0.001) and estrogen receptor (four of 11, P = 0.006) was lower and the number of appendix testes with epithelial destruction was higher (eight of 11, P = 0.001) in group C. We demonstrated that groin hernia and communicating hydrocele did not influence the receptor expression pattern and the anatomic structure of testicular appendages, whereas noncommunicating hydrocele caused damage as indicated by the absence of steroid receptors and destruction of the epithelial surface. A better understanding of the physiological role of testicular appendages may change the indications of surgical treatment in patients with noncommunicating hydrocele.

Keywords: androgen receptor, appendix testis, estrogen receptor, hydrocele

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