Early hormonal and surgical treatment of cryptorchidism.
OBJECTIVE
We investigated the efficacy of early gonadotropin treatment of cryptorchidism for promoting testicular descent and ameliorating testicular histology.


METHODS
We treated 319 cryptorchid testes in 281 boys 4 months to 3 years old with luteinizing hormone-releasing hormone and human chorionic gonadotropin sequential therapy. Surgery was done on the 207 testes that did not respond to medical treatment. Microscopic biopsies were performed in 134 of these 207 testes. Histological findings were compared to those of 30 cryptorchid testes in boys younger than 1 year who underwent surgery without previous hormonal treatment.


RESULTS
Combined luteinizing hormone-releasing hormone and human chorionic gonadotropin treatment induced scrotal descent of a percentage of cryptorchid testes depending on clinical position. Therapeutic success was greater when testes were in a lower position and results were not age dependent. Hormonal treatment of cryptorchidism during the first year of life stimulated spermatogonia maturation.


CONCLUSIONS
When administered at the end of age 6 months, hormonal treatment can be considered an effective and timely substitution for gonadotropin and testosterone insufficiency in cryptorchid infants. Therefore, we recommend this therapeutic procedure combined with surgery in the first year of life.
Lala
R
R
Division of Pediatric Endocrinology (Unit of Pediatric Andrology), Regina Margherita Children's Hospital of Turin, Italy.
Matarazzo
P
P
Chiabotto
P
P
Gennari
F
F
Cortese
M G
MG
Canavese
F
F
de Sanctis
C
C
D000367:Age Factors; D002675:Child, Preschool; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D003456:Cryptorchidism / Q000188:drug therapy* / Q000601:surgery*; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone