Authors
Hosie, S., Loff, S., Witt, K., Niessen, K., Waag, KL.

Title
Is there a correlation between organochlorine compounds and undescended testes?

Journal
European Journal of Pediatric Surgery 2000; 10: 304-309

Summary
The frequency of developmental abnormalities of the male reproductive tract has been reported to be increasing in North America and elsewhere in the world. Cryptorchidism, undescended testes, occurs when one or both of the testes fail to descend into the scrotum. Testicular descent requires the formation of the inguinal canal within the abdominal musculature for the testis to pass through. This process occurs very early on in pregnancy and it is thought that higher maternal estrogen levels in early pregnancy may give rise to the development of cryptorchidism. Persistent chlorinated organic compounds in the environment have been found to possess weak estrogenic activity relative to the endogenous estrogen, estradiol. Prenatal exposure to exogenous estrogenic chemicals could therefore contribute to the etiology of cryptorchidism.

The paper by Hose et al. is the first case-control study that has been specifically designed to investigate the levels of organochlorines in the fatty tissues of children with cryptorchidism. Children with cryptorchidism often undergo orchidopexy, a surgery done to mobilize a testis, bring it into the scrotum and attach it so that it will not retract. The authors obtained fat samples from 48 patients undergoing surgical procedures including, 18 children who underwent either unilateral (n=8) or bilateral (n=10) orchidopexy. The other 30 children's fat samples were used as a control group. This group was slightly younger in age (mean age 3.5 yrs) than the cases (mean age 4.2 yrs). The tissue samples of both groups were later measured for several organochlorine compounds including; DDT and its metabolites, polychlorinated biphenyls (PCBs), toxaphene, hexachlorocyclohexane (HCH), chlorinated cyclodienes, and chlorinated benzenes.

All of the organochlorines examined for were detected in every patient but the levels were highly variable and not normally distributed. Organochlorine levels were compared between the cases and controls using a two-tailed Mann-Whitley-Wilcoxin test. Significantly higher levels of HCE, heptachlororepoxide (p=0.009) and HCB, hexachlorobenzene (p=0.012) were found in children undergoing orchidopexy. HCE is a chlorinated cyclodiene insecticide that has shown high bioaccumulation while HCB is a fungicide, a rubber additive and PVC (polyvinyl chloride) softener. Both HCB and HCE have been banned in a number of developed countries for over two decades.

This study is limited due to its small sample size and the uncertainty surrounding the characteristics of the control group. Only the mean age of the control group is described, leaving us to question their disease status, reason for surgery and how they were chosen for the study. Nevertheless, these results suggest that increased levels of HCB and HCE may contribute to the etiology of cryptorchidism which warrants further investigation.