Bilateral vanished testes diagnosed with a single blood sample showing very high gonadotropins (follicle-stimulating hormone and luteinizing hormone) and very low inhibin B

Thorup, Jørgen; Petersen, Bodil Laub; Kvist, Kolja; Cortes, Dina

doi:10.3109/00365599.2011.609833

Cited by 19 publications

(19 citation statements)

References 18 publications

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“…Diagnostic laparoscopy is performed to determine surgical therapy in the same manner as for unilateral, non-palpable undescended testes. No response to hCG stimulation, increased serum levels of FSH and very low levels of inhibin B in boys with bilateral non-palpable testes prove that testicular tissue is not present [ 86 ].…”

Section: Treatmentmentioning

confidence: 99%

Undescended testis – current trends and guidelines: a review of the literature

Niedzielski¹,

Oszukowska²,

Słowikowska-Hilczer³

2016

aoms

121

145

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The best mode of undescended testis (UDT) treatment remains controversial. However, knowledge gained from randomized controlled studies and meta-analyses allowed different groups of researchers to set out guidelines on management of patients with UDT. The authors reviewed recent literature and came to the following conclusions: (1) Hormonal treatment is not recommended, considering both the immediate results (only 15–20% of retained testes descend) and the possible long-term adverse effects on spermatogenesis. (2) Surgery is the treatment of choice; orchiopexy is successful in about 95% of UDT, with a low rate of complications (about 1%). (3) Orchiopexy should be performed between 12 and 18 months of age, or at first contact if diagnosed later.

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Section: Treatmentmentioning

confidence: 99%

Undescended testis – current trends and guidelines: a review of the literature

Niedzielski¹,

Oszukowska²,

Słowikowska-Hilczer³

2016

aoms

121

145

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“…Indeed, boys with bilateral cryptorchidism showed higher levels of inhibin B, associated with lower FSH and LH levels, than boys with bilateral vanished testes. However, even in this paper, all hormonal serum levels tested outside the normal range in cryptorchid subjects [ 47 ]. In contrast, the same work group did not find any difference between unilateral cryptorchidism and unilateral vanished testis in terms of inhibin B levels: this may be due to some degree of contralateral testicular compensation [ 48 ].…”

Section: Discussionmentioning

confidence: 94%

“…Thorup et al have investigated gonadotropin and inhibin B levels and number of germ cells at biopsy in cryptorchid children before and after surgery to better define the future fertility outcome: good fertility after orchidopexy was associated with normal levels of inhibin B, normal numbers of germ cells and normal for age levels FSH and LH, which were high before surgery. Children with lack of normalization of FSH and LH and with no increase of inhibin B after surgery had some degree of testicular dysfunction, while children with normal levels of FSH and LH associated with decreased germ cell number showed transient hypothalamus-pituitary-gonadal dysfunction and consequently a decrease in fertility potential [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Inhibin B in healthy and cryptorchid boys

Esposito¹,

Cofini²,

Rigante³

et al. 2018

Ital J Pediatr

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BackgroundCryptorchidism, the most common male genital abnormality observed in paediatrics, might often be associated with long-term functional consequences and can even reoccur after a successful orchidopexy. Serum markers that identify cryptorchid boys with gonadal dysfunction early should be useful in a decision-making process. Inhibin B, produced during all of childhood but altered in cryptorchid subjects, appears strictly related to Sertoli cells, and its levels directly reflect the status of the testis germinative epithelium. Unfortunately, its precise roles in bilateral and unilateral cryptorchidism are still debated and being unravelled. Herein, we report the most current knowledge about inhibin B in both healthy boys and those with cryptorchidism to discuss and clarify its potential clinical applications.DiscussionInhibin B represents a simple and repeatable serum marker and it seems to well asses the presence and function of the testicular tissue. Testicular tissue in prepubertal age is largely made up of Sertoli cells; inhibin B, coming from working Sertoli cells, allows to indirectly evaluate their function. Besides, inhibin B is produced throughout childhood, even before puberty, in contrast with central hormones, and it is not influenced by androgens during puberty, in contrast with other testicular hormones. Although further studies are needed, low levels of inhibin B have been related with low testicular score and/or with consistent alterations of testicular parameters at histological examination. This means that inhibin B could be an indirect marker of testicular functions that could even replace testicular biopsies, but current data are inconsistent to confirm this potential role of inhibin B in cryptorchidism.ConclusionInhibin B represents an effective candidate for early identification of testicular dysfunction after orchidopexy for cryptorchidism. Unfortunately, current data cannot exactly clarify the real role of inhibin B as a predictor of future testicular function in cryptorchidism and future long-term follow-up studies, with repeated inhibin B checks both in cryptorchid and in formerly cryptorchid children and adolescents, will permit to assess if previous normal levels of inhibin B would match with future normal pubertal development and fertility potential.

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“…Then laparoscopy/surgery can be postponed some months to identify and, if present, remove testicular remnants/nubbins in order to avoid leaving those absolutely extremely rare remnants/nubbins with left viable germ cells and only casuistic described malignant potential in situ [Thorup et al, 2011a;Shepard and Kraft, 2017].…”

Section: Neonatal Periodmentioning

confidence: 99%

Surgical Management of Undescended Testis - Timetable and Outcome: A Debate

Thorup

Cortes

2019

Sex Dev

Self Cite

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Around 1.4-3.8% of boys in the Western world are operated because of cryptorchidism. This means that orchidopexy remains one of the most common surgical procedures performed in boys. As a consequence, several consensus reports, guidelines, and reviews dealing with the management of cryptorchidism have been published recently. Based on our research and 30 years' experience with the management of cryptorchidism, the intention of the present publication is to advise on the surgical management and comment on the expected outcome, especially with focus on the controversies related to guidelines and reviews. Except for late referral and waiting lists, which may be practical problems, there is no reason to postpone orchidopexy for nonsyndromic congenital cryptorchid testes beyond 6 months. There is good evidence that such strategy improves the fertility potential and decreases the risk of testicular cancer. In cases with genuine gonadotropin insufficiency, early surgical correction is not enough and adjuvant LH-RH treatment should be implemented to improve the fertility potential. Cryopreservation may be an option in case of treatment failure of adjuvant LH-RH. A prerequisite for such management includes serum hormone assessment and evaluation of testicular biopsies at orchidopexy. Ascended testes contribute to 20-60% of operative cases and should be treated when diagnosed.

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Bilateral vanished testes diagnosed with a single blood sample showing very high gonadotropins (follicle-stimulating hormone and luteinizing hormone) and very low inhibin B

Cited by 19 publications

References 18 publications

Undescended testis – current trends and guidelines: a review of the literature

Undescended testis – current trends and guidelines: a review of the literature

Inhibin B in healthy and cryptorchid boys

Surgical Management of Undescended Testis - Timetable and Outcome: A Debate

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