A systematic review and meta-analysis of comparative studies assessing the efficacy of luteinizing hormone-releasing hormone therapy for children with cryptorchidism

Li, Tao; Gao, Liang; Chen, Peng; Bu, Siyuan; Cao, Deliang; Yang, Lu; Wei, Qiang

doi:10.1007/s11255-016-1235-x

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…Meta-analyses of randomized, blinded studies on hCG treatments showed a success rate of 19% (224), whereas GnRH studies showed a 21% success rate. These results represent a marginal improvement when compared to the placebo (4-6% success rate) (16,224,226). Notably, the reported success rates of orchiopexy have been more than 70% in most studies (218,225).…”

Section: Role Of Hormonal Treatment In Cryptorchidismmentioning

confidence: 94%

Hypogonadism and Cryptorchidism

et al. 2020

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Congenital cryptorchidism (undescended testis) is one of the most common congenital urogenital malformations in boys. Prevalence of cryptorchidism at birth among boys born with normal birth weight ranges from 1.8 to 8.4%. Cryptorchidism is associated with a risk of low semen quality and an increased risk of testicular germ cell tumors. Testicular hormones, androgens and insulin-like peptide 3 (INSL3), have an essential role in the process of testicular descent from intra-abdominal position into the scrotum in fetal life. This explains the increased prevalence of cryptorchidism among boys with diseases or syndromes associated with congenitally decreased secretion or action of androgens, such as patients with congenital hypogonadism and partial androgen insensitivity syndrome. There is evidence to support that cryptorchidism is associated with decreased testicular hormone production later in life. It has been shown that cryptorchidism impairs long-term Sertoli cell function, but may also affect Leydig cells. Germ cell loss taking place in the cryptorchid testis is proportional to the duration of the condition, and therefore early orchiopexy to bring the testis into the scrotum is the standard treatment. However, the evidence for benefits of early orchiopexy for testicular endocrine function is controversial. The hormonal treatments using human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) to induce testicular descent have low success rates, and therefore they are not recommended by the current guidelines for management of cryptorchidism. However, more research is needed to assess the effects of hormonal treatments during infancy on future male reproductive health.

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Section: Role Of Hormonal Treatment In Cryptorchidismmentioning

confidence: 94%

Hypogonadism and Cryptorchidism

et al. 2020

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“…The success rate of testicular descent with intranasal luteinizing hormonereleasing hormone (LHRH) therapy was as low as about 20% in prescrotal or inguinal palpable undescended testis, but not in impalpable testis. 41) However, LHRH therapy can cause hydrocele requiring surgery, penile growth, pubic hair, frequent erection, and behavioral problems. 41) GnRH/LHRH therapy can also harm germ cells and suppress their numbers.…”

Section: Hormonal Therapymentioning

confidence: 99%

“…41) However, LHRH therapy can cause hydrocele requiring surgery, penile growth, pubic hair, frequent erection, and behavioral problems. 41) GnRH/LHRH therapy can also harm germ cells and suppress their numbers. 45) Longterm followup of GnRH/LHRH therapy has not been reported yet.…”

Section: Hormonal Therapymentioning

confidence: 99%

Comparison of diagnostic and treatment guidelines for undescended testis

Shin

Jeon

2020

Clin Exp Pediatr

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Cryptorchidism or undescended testis is the single most com mon genitourinary disease in male neonates. In most cases, the testes will descend spontaneously by 3 months of age. If the testes do not descend by 6 months of age, the probability of spontaneous descent thereafter is low. About 1%-2% of boys older than 6 months have undescended testes after their early postnatal descent. In some cases, a testis vanishes in the abdomen or reascends after birth which was present in the scrotum at birth. An inguinal undescended testis is sometimes mistaken for an inguinal hernia. A surgical specialist referral is recommended if descent does not occur by 6 months, unde scended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. International guidelines do not recommend ultrasonography or other diagnostic imaging because they cannot add diagnostic accuracy or change treat ment. Routine hormonal therapy is not recommended for undescended testis due to a lack of evidence. Orchiopexy is recommended between 6 and 18 months at the latest to pro tect the fertility potential and decrease the risk of malignant changes. Patients with unilateral undescended testis have an infertility rate of up to 10%. This rate is even higher in patients with bilateral undescended testes, with intraabdominal un de scended testis, or who underwent delayed orchiopexy. Pa tients with undescended testis have a threefold increased risk of testicular cancer later in life compared to the general pop ulation. Selfexamination after puberty is recommended to facilitate early cancer detection. A timely referral to a surgical specialist and timely surgical correction are the most important factors for decreasing infertility and testicular cancer rates.

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“…Despite apparent success in individual patients, the possibility of unrelated spontaneous descent of retractile testes cannot be excluded in the absence of randomization and the effect does not seem sufficiently powerful to justify routine clinical use. However, targeted neonatal treatment for cryptorchid boys with absent minipuberty might reveal significantly higher success rates (75,76). Table 1 summarizes available studies on gonadotropin treatment in order to replace minipuberty in infants with congenital hypogonadotrophic hypogonadism (77)(78)(79)(80)(81)(82)(83).…”

Section: Minipuberty and Early Assessment Of Hypogonadismmentioning

confidence: 99%