Jimenez Cruz F, Escudero Solano B
Eur Urol. 1979;5(3):168-72. doi: 10.1159/000473097.
We studied 4 patients who were under consultation for secondary 'impotence coeundi' and who had had normal puberal development (degree V in the Tanner's scale). 2 of them had children. In the diverse diagnostic attempts, basal deficits of FSH, LH and testosterone were repeatedly confirmed. Stimulation with HCG was positive. Stimulation with Gn-RH did not modify the basal deficient values. Stimulation with clomiphene in 1 case was also negative. The determinations of ACTH, TSH, metopirone test and PBI were normal. In the spermiograms there was oligoasthenozoospermia. We have not found antecedents that justify the hormonal insufficiency, thus we consider that it is a selective deficit of FSH and LH and of hypothalamic or pituitary postpuberal idiopathic genesis. Sexual potency was quickly regained when the patients were treated with HCG. In every case the dose was adjusted to allow therapeutics.
我们研究了4例因继发性“性交无能”前来咨询且青春期发育正常(坦纳分期为V度)的患者。其中2例有子女。在各种诊断检查中,促卵泡生成素(FSH)、促黄体生成素(LH)和睾酮的基础水平缺乏反复得到证实。人绒毛膜促性腺激素(HCG)刺激试验呈阳性。促性腺激素释放激素(Gn-RH)刺激试验未改变基础缺乏值。1例患者克罗米芬刺激试验也为阴性。促肾上腺皮质激素(ACTH)、促甲状腺激素(TSH)、美替拉酮试验和蛋白结合碘(PBI)测定均正常。精液检查显示少弱精子症。我们未发现可解释激素缺乏的既往史,因此认为这是一种FSH和LH的选择性缺乏,源于青春期后下丘脑或垂体特发性病变。患者接受HCG治疗后性功能迅速恢复。在每种情况下,剂量都根据治疗需要进行调整。