Management of the non‐descended testis: doubtful value of luteinizing‐hormone‐releasing‐hormone (LHRH). A double‐blind, placebo‐controlled multicentre study

Abstract

In a double-blind, placebo-controlled multicentre study, the effect of luteinizing-hormone-releasing-hormone (LHRH) in 141 boys was analysed after 4-week treatment period with 0.4 mg LHRH nasal spray or placebo nasal spray three times daily. Data from 123 boys was analysed, with 62 boys in the treatment group and 61 in the placebo group. Full response i.e. the testis at the bottom of the scrotum on both sides in boys with bilaterally undescended testes, was found in six patients, one of them in the placebo group [Therapeutic gain of LHRH with 95% CI: 8.1% (0.1-16.6%, P = 0.12)]. Only in these boys could surgery be avoided. Considering the number of testes (and not the number of boys) a significant effect was found on at least one testis in 25% of boys with bilaterally undescended testes [Therapeutic gain with 95% CI: 24.0% (13.2-34.8%, P = 0.001)]. In unilateral undescended testes, the LHRH treatment showed no effect (P = 1.00). The inclusion of retractile testes did not affect our results. In our opinion LHRH has a limited place in treatment of the non-descended testis.

Effectiveness of Hormonal and Surgical Therapies for Cryptorchidism: A Systematic Review

“…25,26 Three studies were of good quality, 17,23,25,26 2 were of fair quality, 14,15 and 9 were of poor quality. [9][10][11][12][13]16,[18][19][20][21][22]24 Six studies 9-16 specifically compared successful testicular descent rates after administration of LHRH versus placebo (2 fair quality 14,15 and 4 poor quality [9][10][11][12][13]16 ). Five of 6 studies concluded that LHRH was more effective than placebo in inducing testicular descent with variable reported effect sizes across studies, whereas 1 study was equivocal (see Table 2).…”

“…Five of 6 studies concluded that LHRH was more effective than placebo in inducing testicular descent with variable reported effect sizes across studies, whereas 1 study was equivocal (see Table 2). [12][13][14][15][16] In the 5 studies that appeared to show a benefit to LHRH therapy, 4 did not assess statistical significance at all, whereas 1 failed to document statistical significance likely because of inadequate sample size. No harms of hormonal treatment were reported.…”

Unilateral Double Testes With Spindle Cell Neoplasm (Leiomyoma)- A Case Report

“…Many believe that mechanical cause like internal inguinal obstruction, absent peritoneal vaginalis process, absent gubernaculum, and duct or gonads fusion are certainly relevant factors. 10,11,12 The Vasthasan postulated a classification of CTE considering an eventual aetiology.…”

Germ cell development in the descended and cryptorchid testis and the effects of hormonal manipulation

“…The studies generally agree with Pyorala et al [78] that therapeutic success is greater when the testis is in a lower position and age is not a factor. In addition, four trials reported that it is more effective in bilateral cases rather than unilateral ones [81][82][83][84].…”

“…This paper identified three randomised controlled trials [80][81][82] in addition to the nine trials described by Pyorala et al [78]. Two metaanalyses were performed on the different hormonal treatment comparison trials.…”