Hormonal Treatment of Cryptorchidism

Abstract

60 cryptorchid boys (39 unilateral and 21 bilateral) aged between 10 months and 14 years were treated by conservative methods. All boys received an initial therapy of 200 µg GnRH nasal spray (decapeptide) in each nostril three times daily for 4 weeks. Those who did not respond favorably to the GnRH treatment immediately received a follow-up therapy with 1,500 IU or boys over 7 years 2,000 IU of HCG per week for a total of 3 weeks. Immediately after completion of this therapy, the success rate was 80% (65/81 testes decended). 6 months afterwards 6 of the 48 testes suffered a relapse. Thus, 73% of the testicles were still descended 6 months after completion of therapy.

13 Years’ Experience with the Combined Hormonal Therapy of Cryptorchidism

“…Prefascial ectopia with abnormal gubernaculum attachments, Scarpa’s fascia occluding the entrance of the scrotum, and especially the findings of abnormal fusion of the testis with the epididymis prove the postulation, that the descent of the testis depends on the interaction between the hypothalamic-pituitary-gonadal axis, the gubernaculum and the epididymis [1, 2, 3, 4, 5, 11, 12, 13]. …”

“…Cryptorchidism occurs in approximately 0.8% of 1-year-old males and thus presents the most common disorder of male sexual differentiation. It has been postulated by the early publications of Hadziselimovic et al that the descent of the testis depends on the interaction between the hypothalamic-pituitary-testicular hormonal axis the gubernaculum and the epididymis [1, 2, 3, 4, 5]. …”

“…It is well known that hormonal treatment with LH-RH and HCG can induce scrotal descent of cryptorchid testes [4, 5, 6]. As many as 25 years ago, we were one of the first groups to introduce LH-RH into the therapeutic management of cryptorchidism [5, 6].…”