Hormonal Treatment for Unilateral Inguinal Testis: Comparison of Four Different Treatments

Abstract

Background: Hormonal treatment of cryptorchidism has been used since the 30s, but controversies persist on its efficacy. It is also unclear whether there are differences with the use of different hormonal trials. Aims: To evaluate the efficacy of four hormonal treatments on testicular descent in a homogeneous group of cryptorchid boys. Patients: 155 patients (age 10–48 months) with unilateral inguinal palpable testis were studied. Methods: The patients were subdivided into four groups according to hormonal treatment: group 1 = hCG [500 IU/week (if the chronological age was <2 years) or 1,000 IU/week (if the chronological age was >2 years) for 6 weeks]; group 2 = hCG + hMG (hCG as in group 1 + hMG 75 IU/week for 6 weeks); group 3 = GnRH (1,200 µg/daily for 28 days); group 4 = GnRH + hCG (1,200 µg/daily for 28 days + 1,500 IU/week for 3 weeks, respectively). The results were evaluated at the end of the treatment period and 6 months later to exclude temporarily positive results. Results: At the end of the hormonal therapy, scrotal testicular descent was present in 30 of 155 boys (success rate 19.3%). Seven testes relapsed during follow-up (23.3%). The long-term success rate was 14.8% (23/155 testes). No significant differences were observed in success rates as well as in relapse rates among the four groups. Conclusions: Hormonal therapy induced permanent testicular descent in a minority of young cryptorchid boys with inguinal palpable testis. Similar results were obtained with four different trials.

Effectiveness of Hormonal and Surgical Therapies for Cryptorchidism: A Systematic Review

“…17,24 One study reported that 74% of 116 boys receiving hCG had virilizing effects, compared with 5.1% of boys receiving only LHRH, but 1 of the hCG arms also included LHRH and another included human menopausal gonadotropin. 18 All side effects had receded by the 6-month follow-up. No other study reported side effects to be as common as virilization.…”

“…25,26 Three studies were of good quality, 17,23,25,26 2 were of fair quality, 14,15 and 9 were of poor quality. [9][10][11][12][13]16,[18][19][20][21][22]24 Six studies 9-16 specifically compared successful testicular descent rates after administration of LHRH versus placebo (2 fair quality 14,15 and 4 poor quality [9][10][11][12][13]16 ). Five of 6 studies concluded that LHRH was more effective than placebo in inducing testicular descent with variable reported effect sizes across studies, whereas 1 study was equivocal (see Table 2).…”

Epidemiology, Classification and Management of Undescended Testes: Does Medication Have Value in its Treatment?

“…There are two treatment approaches for undescended testes: hormonal and surgical (31). The treatment of choice is hormonal therapy in Europe since 1930s, while surgery is preferred in the first-line setting in the USA (1,31).…”

“…The treatment of choice is hormonal therapy in Europe since 1930s, while surgery is preferred in the first-line setting in the USA (1,31). The use of hormonal therapy is still controversial in the literature; however, it has been widely used in many centers.…”

“…Although the use of hormonal therapy is still controversial in the literature, it has been used in Europe since 1930s (31). …”