Efficacy and safety of hormonal treatment of cryptorchidism: current state of the art

Þórsson, Árni V.; Christiansen, Peter Munk; Ritzén, Martin

doi:10.1111/j.1651-2227.2007.00238.x

Cited by 54 publications

(33 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cortes and Thorup demonstrated that in one to three year boys with cryptorchidism HCG treatment may be hazardous to germ cells, therefore, they cannot be recommended [9]. Therefore considering the efficacy and the possible side effects of the hormonal treatment, the general use of hCG and GnRH in the treatment of cryptorchidism cannot be further recommended [21][22][23]. Recently we have conducted in the area of Naples (Italy) a retrospective study on cryptorchidism treatment and we have verified that hormonal therapy is still widely diffused and that it may delay the surgical treatment [24].…”

Section: Discussionmentioning

confidence: 99%

Morphologic changes due to human chorionic gonadotropin in the rat testis: Role of vascular endothelial growth factor

Papparella¹,

Nino²,

Noviello³

et al. 2013

OJPed

View full text Add to dashboard Cite

Introduction: Human chorionic gonadotropin (hCG) has an important role in the regulation of reproductive system and a high capacity to stimulate angiogenesis by secretion of vascular endothelial growth factor (VEGF). It could be also used for medical treatment of cryptorchidism, as it stimulates Leydig cells to produce testosterone, but its use has been discussed. Aim of the study was to evaluate the testicular morphological changes due to cyclic administration of hCG possibly related to VEGF effect. Methods: 80 pre-puberal male Sprague-Dawley rats were randomly divided in two groups hCG (50 U/I/ Kg) (n = 55/S) and placebo (n = 25/C) treated. The animals were sacrificed respectively after one (S1 n = 10; C1 n = 5), two (S2 n = 10; C2 n = 5) and three weeks of hCG or placebo treatment (S3 n = 35; C3 n = 15); a blood serum was obtained for evaluation of plasmatic testosterone. The testis, prostates, epididymides and seminal vesicles were drawn and weighted. Specimens were fixed in formalin and coloured by hematoxylin-eosin. Morphometric analysis of Leydig cell number, nuclear area and perimeter was carried out. Immunoistochemistry for VEGF has been performed with the avidin-biotin peroxidase technique. Statistical differences between groups, each of different age, were calculating using Student's T-test. Results: After the first week of hCG treatment it has been observed an increased testicular weight and volume (+/−6%) in experimental respect to control group. This result was not observed after the second and third week of treatment. Significant variations were also observed in the mean prostate weight, whereas mean seminal vesicles weight was significant in the S2 and S3 groups respect to control. In the hCG treated rats it has been observed a poor differentiation of the seminiferous epithelium, with high Leydig cell evidence and increased intertubular eosinophilic material. An interstitial edema was demonstrated without inflammatory cell changes. Morphometric analysis confirmed an increased number of Leydig cells that were always strongly immunostained for VEGF. Low-medium reactivity was present in spermatogonial, peritubular, endothelial and Sertoli cells. Testosterone plasmatic values showed a statistically significant and progressive increase. Conclusions: hCG treatment clutters the germinative line and modifies VEGF testicular expression, suggesting its role in male reproductive system. The increased number of Leydig cells and the immunostaining for VEGF suggests an intense interstitial and metabolic arrangement. The morphologic modifications induced by hCG treatment and its influence on testis function raise the question about its use in the medical treatment of cryptorchidism.

show abstract

Section: Discussionmentioning

confidence: 99%

Morphologic changes due to human chorionic gonadotropin in the rat testis: Role of vascular endothelial growth factor

Papparella¹,

Nino²,

Noviello³

et al. 2013

OJPed

View full text Add to dashboard Cite

show abstract

“…Furthermore, for decades, hCG has been used for maldescensus testis. Just recently, a meta-analysis on the efficacy and safety of this treatment in cryptorchidism made the authors conclude that considering the efficacy of about 20% in combination with possible side effects, the general use of hCG in the treatment of cryptorchidism cannot be further recommended (34). For the management of induction of puberty, hCG alone induces an increase in androgens associated with a pubertal growth spurt and some virilization (35).…”

Section: Gonadotropinsmentioning

confidence: 99%

Inducing puberty

Delemarre

Felius

Waal

2008

European Journal of Endocrinology

View full text Add to dashboard Cite

Puberty is the result of increasing pulsatile secretion of the hypothalamic gonadotropin releasing hormone (GnRH), which stimulates the release of gonadotropins and in turn gonadal activity.In general in females, development of secondary sex characteristics due to the activity of the gonadal axis, i.e., the growth of breasts, is the result of exposure to estrogens, while in boys testicular growth is dependent on gonadotropins and virilization on androgens.Hypogonadotropic hypogonadism is a rare disease. More common is the clinical picture of delayed puberty, often associated with a delay of growth and more often familial occurring. Especially, boys are referred because of the delay of growth and puberty. A short course (3-6 months) of androgens may help these boys to overcome the psychosocial repercussions, and during this period an increase in the velocity of height growth and some virilization will occur.Hypogonadotropic hypogonadism may present in a congenital form caused by developmental disorders, some of which are related to a genetic disorder, or secondary to hypothalamic-pituitary dysfunction due to, among others, a cerebral tumor.In hypogonadotropic hypogonadism puberty can be initiated by the use of pulsatile GnRH, gonadotropins, and sex steroids. Sex steroids will induce development of the secondary sex characteristics alone, while combined administration of gonadotropins and GnRH may induce gonadal development including fertility.European Journal of Endocrinology 159 S9-S15

show abstract

“…El tratamiento con GnRH consiste en la administración intranasal de 1200 µg /día (400 µg, tres veces por día) durante cuatro semanas 50 . La eficacia del tratamiento hormonal es variable según los diferentes estudios, con tasas de éxito que varían entre 0% y 55 % para la hCG, y entre 9% y 78% para la GnRH 51,52 . La eficacia es mayor cuanto más bajas se encuentren las gónadas antes del tratamiento, sin mostrar demasiada diferencia si se realiza en niños prepuberales antes o después de los cuatro años de edad (Ver Figura 7).…”

Section: Tratamientos Hormonalesunclassified

Criptorquidia: desde la embriología al tratamiento

Blanco¹,

Gottlieb

Grinspon

et al. 2015

Rev. Medicas UIS

View full text Add to dashboard Cite

RESUMENLa criptorquidia es la anomalía genital más común en el recién nacido varón y a pesar de que su evaluación y tratamiento han progresado con las décadas, siguen existiendo muchas controversias al respecto. En todo niño, el examen físico genital debe buscar la presencia de las gónadas en el escroto, en su ausencia, debe tratar de distinguirse si la anomalía es unilateral o bilateral, definiéndose con la mayor precisión posible la posición de estas y distinguiéndose entre testículo criptórquido, ectópico y retráctil junto con la valoración de la existencia de tejido testicular funcional a través de estudios hormonales. El tratamiento puede ser hormonal o quirúrgico, este último no se recomienda antes del año de edad además corresponde a la terapia más exitosa para reubicar el testículo en el escroto en aquellos pacientes con gónadas en posición inguinal alta, abdominal o en posición ectópica, o en aquellos en los que la terapia hormonal ha fallado. Por otro lado, la terapia hormonal se recomienda en mayor medida cuando las gónadas están en posición inguinal media, baja o escrotal alta. El tratamiento apunta a reducir, aunque no siempre logra evitar los posibles problemas a largo plazo de infertilidad y cáncer de testículo. MÉD UIS. 2015;28(3):371-80.Palabras clave: Fertilidad. Neoplasia Testicular. Orquidopexia. Cryptorchidism: from embryology to treatment ABSTRACTCryptorchidism is the most frequent genital anomaly in the newborn male. Although significant progress has been made in the assessment and treatment of cryptorchidism, several controversies still exist. In every boy, the physical examination should seek the presence of the gonads in the scrotum. Otherwise, it should be made clear whether cryptorchidism is unilateral or bilateral, the position of the gonad should be defined as precisely as possible, distinguishing between cryptorchidism, ectopia and retractile testes. Hormonal laboratory studies help assessing the existence of functional testicular tissue. Treatment may be hormonal or surgical. The latter is not recommended before the age of 1 year. Surgery has the highest rates of success in patients with gonads in high inguinal, abdominal or ectopic position, or when hormonal treatment has failed. Hormonal treatment may be successful in patients with gonads in low inguinal or high scrotal position. Treatment aims to reduce, although it does not always avoids, the risks of infertility and of testicular cancer in the long term. MÉD UIS. 2015;28(3):371-80.

show abstract

Efficacy and safety of hormonal treatment of cryptorchidism: current state of the art

Cited by 54 publications

References 29 publications

Morphologic changes due to human chorionic gonadotropin in the rat testis: Role of vascular endothelial growth factor

Morphologic changes due to human chorionic gonadotropin in the rat testis: Role of vascular endothelial growth factor

Inducing puberty

Criptorquidia: desde la embriología al tratamiento

Contact Info

Product

Resources

About