Merksz M, Tóth J, Pirót L
Department of Urologic Surgery, Heim Pál Children's Hospital, Budapest, Hungary.
Int Urol Nephrol. 1992;24(4):429-37. doi: 10.1007/BF02550638.
Testicular testosterone (T) production was examined in thirty boys with undescended testes (UT) following the administration of 4500 U gonadotropic hormone. Twenty boys had bilateral UT and ten had UT plus hypospadias. As for possible causes of reduced Leydig cell activity it was investigated whether the testis was (1) hypoplastic; (2) abnormally fused with the epididymis; (3) located in the abdomen; (4) or UT was associated with hypospadias. Average T values were significantly lower when the testicle was hypoplastic or its fusion with the epididymis was imperfect; but remained largely undiminished when the testicle was located in the abdomen or when UT was combined with hypospadias. The occurrence of both pathologic and physiologic T reactions in each of the four groups suggests that the population of UT children is heterogeneous, probably due to differences in aetiology and in intrauterine hormonal processes. In the case of UT and hypoplasia the time and method of operation (orchidopexy) must be selected with utmost care, bearing in mind that an originally small testicle with impaired T secretion may become physiologic by the time of puberty.
在给予4500单位促性腺激素后，对30名隐睾男孩的睾丸睾酮（T）生成情况进行了检查。20名男孩为双侧隐睾，10名男孩为隐睾合并尿道下裂。关于睾丸间质细胞活性降低的可能原因，研究了睾丸是否（1）发育不全；（2）与附睾异常融合；（3）位于腹部；（4）或隐睾与尿道下裂相关。当睾丸发育不全或其与附睾的融合不完美时，平均T值显著降低；但当睾丸位于腹部或隐睾合并尿道下裂时，T值基本未降低。四组中均出现了病理性和生理性T反应，这表明隐睾儿童群体具有异质性，可能是由于病因和宫内激素过程的差异所致。对于隐睾和发育不全的情况，在选择手术（睾丸固定术）时间和方法时必须极其谨慎，要记住原本分泌T受损的小睾丸在青春期时可能会恢复生理功能。
