Zucchini S, Cacciari E
Clinica Pediatrica I, Università degli Studi di Bologna, Italia.
Pediatr Med Chir. 1996 Sep-Oct;18(5 Suppl):35-6.
There is still a debate on the choice of medical or surgical approach for the management of the undescended testis and on their efficacy in preventing long-term complications. HCG has long been used, with various schedules, in the treatment of cryptorchidism. A complete descent occurs in 14-59% of cases, with the highest percentages in older children and the lowest in intra-abdominal testes. The usefulness of intranasally administered LHRH is even more controversial and its potency seems inferior to HCG. In the last decades the surgical intervention has been recommended at progressively earlier ages. Our opinion is that the orchiopexy is inevitable, around age 2 years, if medical treatment has failed and the gonad is located intra-abdominally or high in the inguinal canal. In contrast, if the testis shows a partial response to medical treatment and is close to the scrotum, a second HCG course can be performed around age 4 years.
对于隐睾的治疗,在选择药物治疗还是手术治疗以及它们预防长期并发症的疗效方面仍存在争议。长期以来,人绒毛膜促性腺激素(HCG)一直以各种方案用于治疗隐睾症。14% - 59%的病例会完全下降,年龄较大的儿童下降比例最高,腹腔内睾丸下降比例最低。经鼻给予促性腺激素释放激素(LHRH)的有效性更具争议,其效力似乎低于HCG。在过去几十年中,手术干预的推荐年龄越来越早。我们的观点是,如果药物治疗失败且性腺位于腹腔内或腹股沟管高位,在2岁左右进行睾丸固定术是不可避免的。相反,如果睾丸对药物治疗有部分反应且接近阴囊,可以在4岁左右进行第二个HCG疗程。