Hormonal cryptorchidism therapy: systematic review with metanalysis of randomized clinical trials

Henna, Marcia Riromi; Nero, Rozemeire G. M. Del; Sampaio, Cristina; Atallah, Álvaro Nagib; Schettini, Sergio Crescenzo Antonio; Castro, Aldemar Araújo; Soares, Bernardo

doi:10.1007/s00383-004-1198-3

Cited by 72 publications

(47 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in the meta-analysis of the results of pooled data for uni-and bilateral cases, there was no signifi cant difference in effi cacy between patients older or less than 4 years [ 18 , 24 ]. Henna et al [ 24 ] reviewed all randomised trials until June 2003, adding three trials to the nine reviewed by Pyorala et al [ 18 ]. A meta-analysis on two randomised controlled trials comparing hCG versus GnRH reported success rates of 25 % and 18 %, respectively.…”

Section: Efficacy Of Hormonal Treatment Of Cryptorchidismmentioning

confidence: 97%

Hormonal Treatment

Hutson¹,

Thorup²,

Beasley³

2015

Descent of the Testis

View full text Add to dashboard Cite

Section: Efficacy Of Hormonal Treatment Of Cryptorchidismmentioning

confidence: 97%

Hormonal Treatment

Hutson¹,

Thorup²,

Beasley³

2015

Descent of the Testis

View full text Add to dashboard Cite

“…This includes the completion of testis descent, which often occurs after birth commensurate with the neonatal surge in testosterone levels (40). Furthermore, hCG injections that produce a significant rise in testosterone levels have been a time-honoured method for medical management of undescended testis (41). It seems that a high local concentration of testosterone is required to mediate these effects, but what is the mechanism?…”

Section: Inguinoscrotal Phasementioning

confidence: 99%

Factors controlling testis descent

Hughes¹,

Acerini²

2008

European Journal of Endocrinology

139

View full text Add to dashboard Cite

Descent of the testis from an intra-abdominal site in foetal life to an extracorporeal location after birth is a mandatory developmental process to ensure that the mature testis promotes normal spermatogenesis. The two phases of transabdominal and inguinoscrotal descent occur approximately during the first and last thirds of gestation respectively. Key anatomical events to release the testis from its urogenital ridge location and to guide the free gonad into the scrotum are the degeneration of the cranio-suspensory ligament and a thickening of the gubernaculum. Androgens play a role in both these processes, particularly with respect to enabling the testis to traverse the inguinal canal in the final phase of descent. Experiments in animals suggest that androgens mediate this effect via the release of calcitonin gene-related peptide by the genitofemoral nerve, but direct evidence for such a mechanism is lacking in humans. The transabdominal phase of descent is under the control of insulinlike 3 (INSL3), a product of the Leydig cells. Definitive evidence of its role in rodent testis descent is illustrated by the phenotype of bilateral cryptorchidism in Insl3K/K null mice. Circulating levels of INSL3 are higher in boys at puberty, are undetectable in girls and are lower in boys with undescended testes. A minority also have a mutation either in the INSL3 gene or affecting its receptor gene, relaxin/insulin-like family peptide receptor 2 (LGRF8). Other factors that may play a role in testis descent include the anti-Mullerian hormone and members of the HOX gene family. Evidence that the prevalence of undescended testis may be increasing provides a phenotypic readout for the effects of postulated chemicals in the environment interfering in some way with the action of factors that control testis descent. Epidemiological studies point to profound geographical variations in prevalence in countries such as Denmark and Finland. Associations have been found with levels of chemicals labelled as endocrine disruptors being higher in breast milk samples from mothers with cryptorchid boys when compared with controls. The adverse effects of these compounds (e.g. bisphenol A) can be replicated in the offspring of dams exposed during pregnancy. A sensitive marker of an anti-androgen effect of a compound is a reduction in the anogenital distance, an anthropometric measurement that is significantly greater in males compared with females. The observation of an association between the anogenital distance in infant boys and the level of pesticides in the urine of their mothers in late gestation indicates that this has the potential to be a useful surrogate marker of the effects of environmental chemicals on testis descent in human population studies. The rightful place for the testis at birth is in the scrotum in order to provide the temperature differential essential for normal spermatogenesis. Appropriate screening programmes and early surgical intervention are the prerequisites to ensure optimal fertility in adulthood and a con...

show abstract

“…This would ultimately cause in utero impairment of Leydig cell function with diminished testosterone (and Insl3) production, resulting in abnormal epididymal and gubernacular development, ultimately causing testicular maldescent [14]. However, hormonal therapy in cryptorchidism to stimulate testosterone production has not shown to be effective in causing testicular descent [15]. Furthermore, there are no reports of abnormal gonadotrophin or androgen levels (that might explain cryptorchidism) in newborn infants with PUV.…”

Section: Hormonal Imbalance Due To Renal Impairmentmentioning

confidence: 98%