Fertility prospects for the prune-belly patient: A scoping review

Lane Shish; Erin Reardon; Stanley Kogan

doi:10.1016/j.jpurol.2024.01.005

Fertility prospects for the prune-belly patient: A scoping review

J Pediatr Urol. 2024 Jan 11:S1477-5131(24)00008-1. doi: 10.1016/j.jpurol.2024.01.005. Online ahead of print.

Authors

Lane Shish¹, Erin Reardon², Stanley Kogan³

Affiliations

¹ University of Minnesota, Department of Urology, Minneapolis, MN, USA. Electronic address: shish020@umn.edu.
² University of Minnesota, Health Sciences Library, Minneapolis, MN, USA.
³ Wake Forest University, Pediatrics and Regenerative Medicine, Winston-Salem, NC, USA.

PMID: 38267308
DOI: 10.1016/j.jpurol.2024.01.005

Abstract

Introduction: With advances in medical care and assisted reproductive technologies (ART), fertility prospects for prune-belly syndrome (PBS) men may be changing. This review aims to identify the factors influencing fertility and optimization of reproductive health for PBS patients.

Material and methods: A scoping review was performed on all records published over 70 years (1952-2022) analyzing fertility in PBS males. Records were summarized in a table and narrative describing cryptorchidism, orchiopexy, testicle histology; prostate characteristics; sex hormone function; semen analyses, ART, and conception ability. This review was registered on Open Science Framework (OSF) and conducted using PRISMA methodology.

Results: 827 articles were identified and 83 were selected for data extraction. Before 2000, there were 0.85 publications/year whereas after 2000 there were 1.95 publications/year. Orchiopexy successfully relocated 86 % of PBS testicles into the scrotum. Testicular histology demonstrated 50 % of patients had no spermatogonia, while 47.2 % and 2.7 % had reduced or normal numbers respectively. Leydig hyperplasia and Sertoli only histology were found in 19.4 % of patients. Prostatic hypoplasia and prostatic urethral dilation were found in 93.6 % and 91.4 % of patients respectively. Testosterone, Luteinizing hormone (LH) and Follicle-stimulating hormone (FSH) were normal in 93.9 %, 87.7 % and 77.9 % of patients respectively. Azoospermia and oligospermia was found in 75.7 % and 21.6 % of patients respectively while 60.7 % had antegrade ejaculation. ART successfully extracted sperm in 6 instances and resulted in 4 conceptions, while natural conception was reported twice.

Conclusions: Data analysis indicates increased attention to fertility prospects for PBS males with evaluation of PBS patient's hormonal function, semen analyses, ART, and conception ability. The reviewed data suggest that PBS males may father biological offspring with contemporary management and also demonstrate the need for consistent reproductive management approaches to maximize their fertility prospects.

Keywords: Eagle–barrett syndrome; Fertility; Prune-belly syndrome.

Publication types

Review