Therapeutic results in cryptorchidism after combination therapy with LH-RH nasal spray and hCG

Waldschmidt, J.; El-Dessouky, Mohamed A.; Priefer, A.

doi:10.1007/bf00452866

Cited by 19 publications

(9 citation statements)

References 17 publications

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“…While other studies have shown lower treatment success in the youngest patients [12,191, optimal effect was obtained in this study in 52% of 33 patients [l 11. In the other patient population, hCG was given immediately after treatment with GnRH, and testicular descent (to scrota1 bottom) was obtained for 86.4% of 81 initially undescended testicles in 72 boys [19]. Thus, the treatment success is lower in the present study than in the two uncontrolled studies mentioned above.…”

Section: Discussionmentioning

confidence: 47%

Effect of a Combined GnRH/HCG Therapy in Boys with Undescended Testicles: Evaluated in Relation to Testicular Localization within the First Week After Birth

Fedder

Boesen

1998

Archives of Andrology

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Among 509 boys referred with undescended testicles, 112 had true undescended testicles unilaterally and 62 bilaterally. Patients with true undescended testicles were offered hormonal treatment unless the condition was associated with hernia or previous operations. Boys less than 5 years old were primarily treated with gonadotrophin releasing hormone (GnRH), while boys more than 5 years old were primarily treated with human chorionic gonadotrophin (hCG). If the effect of the primary treatment was insufficient the other hormone was given. Testicular descent was obtained for 64% (23/36) of the intraabdominally located testicles in boys with bilaterally undescended testicles versus only 14% (3/21) in boys with unilaterally undescended testicles (p < .001). Treating 1 to 4 years old boys with GnRH resulted in descent in 16 of 95 testicles and secondary treatment with hCG yielded an additional 34, whereas secondary treatment of 5 to 13 years old boys with GnRH added only 10 descended testicles to 51 of 101 testicles. Reading the maternity records of 272 of the boys support other studies showing that testicles may reascend. Boys with endocrinological or "surgical" causes of incomplete testicular descent were relatively more likely to have had one or two undescended testicles during the first postnatal week compared with boys found to have only retractile testicles (p < .001). Treatment with hormones resulted in descent in 56% of boys whose testicles were both descended within one week after birth. Conversely, only 1 of 20 boys with unilateral testicular undescent postnatally was sufficiently treated with hormones (p < .001). The hormonal effect in boys with bilaterally undescended testicles at delivery did not differ significantly from boys with either one or none undescended testicle postnatally. In 35 of 51 boys (69%) in whom the hormonal effect was insufficient, operation revealed a "surgical cause" of the incomplete testicular descent.

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Section: Discussionmentioning

confidence: 47%

Effect of a Combined GnRH/HCG Therapy in Boys with Undescended Testicles: Evaluated in Relation to Testicular Localization within the First Week After Birth

Fedder

Boesen

1998

Archives of Andrology

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“…Cryptorchidism has also been treated with synthetic analogs of LHreleasing hormone (LHRH) (42-44), and combined hormonal therapy with hCG and LHRH (45)(46)(47). The success rates have been reported to vary from 0 to 55% with hCG (48) and from 9 to 78% with LHRH (49).…”

Section: Discussionmentioning

confidence: 99%

Germ cell apoptosis after treatment of cryptorchidism with human chorionic gonadotropin is associated with impaired reproductive function in the adult.

Dunkel¹,

Taskinen²,

Hovatta³

et al. 1997

J. Clin. Invest.

150

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Cryptorchidism results in impaired fertility. Reduced numbers of testicular germ cells can be shown histologically during the first years of life. The process causing germ cell loss in cryptorchid prepubertal boys is unknown, but it could be the result of a form of programmed cell death known as apoptosis. 25 adult men with a history of surgically treated cryptorchidism were studied, 15 of whom had received an unsuccessful human chorionic gonadotropin (hCG) therapy before orchidopexy. Apoptotic DNA fragmentation was assayed in testis biopsies taken during orchidopexy by endlabeling, both in extracted DNA and histochemically in situ. Only a few scattered apoptotic spermatogonias were seen by end-labeling of biopsies from patients not treated with hCG, whereas more extensive labeling of spermatogonia was seen after hCG treatment. As estimated by gel electrophoresis, the amount of low molecular weight DNA was 4.3-fold higher in the hCG-treated group when compared with the level in scrotal testis of non-hCG-treated patients ( P Ͻ 0.001). About 20 yr after the biopsy, the low molecular weight DNA fragmentation correlated negatively with the testis volume ( r ϭ Ϫ 0.84; P Ͻ 0.001) and positively with serum FSH levels ( r ϭ 0.73; P Ͻ 0.001). Findings in the semen analysis were similar between the groups. Apoptotic loss of spermatogonia after hCG treatment of cryptorchidism warrants reevaluation of the safety of this treatment. ( J. Clin. Invest.

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“…Tag 1000 IV i. m. bei> 6jährigen (insgesamt 5000 IV)] nur unmittelbar nach ausbleibendem oder nur partiellem Erfolg der vierwöchigen Gn-RH-Therapie (Mißerfolg bei ca. 50%) empfohlen (34). Bei einer Nachbeobachtungszeit von 24 Monaten konnte mit dieser Therapie eine Senkung der Rezidivrate von 77 auf 30% erreicht werden (34 …”

Section: Medikamentöse Maßnahmenunclassified

“…50%) empfohlen (34). Bei einer Nachbeobachtungszeit von 24 Monaten konnte mit dieser Therapie eine Senkung der Rezidivrate von 77 auf 30% erreicht werden (34 …”

Section: Medikamentöse Maßnahmenunclassified

Aktuelle Diagnostik und Therapie des Maldeszensus testis*

Schaefer¹,

Brühl²,

Jankowski³

1989

Klin Padiatr

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Although the etiology of maldescended testes is multifactorial, dysfunction of hypothalamic-pituitary-gonadal axis should be considered as the most important factor. The hormonal treatment with Gn-RH on its own or followed by hCG can provoke testicular descent and should be applied at 10th month of life. Failure, partial or transient success needs orchidopexy within the first two years of life to prevent infertility. If a concomitant hernia or a true ectopia is encountered, if patients are seen at an adolescent age and if the testes are truly cryptorchid, surgery is the treatment of choice.

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Therapeutic results in cryptorchidism after combination therapy with LH-RH nasal spray and hCG

Cited by 19 publications

References 17 publications

Effect of a Combined GnRH/HCG Therapy in Boys with Undescended Testicles: Evaluated in Relation to Testicular Localization within the First Week After Birth

Effect of a Combined GnRH/HCG Therapy in Boys with Undescended Testicles: Evaluated in Relation to Testicular Localization within the First Week After Birth

Germ cell apoptosis after treatment of cryptorchidism with human chorionic gonadotropin is associated with impaired reproductive function in the adult.

Aktuelle Diagnostik und Therapie des Maldeszensus testis*

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