Lala R, Matarazzo P, Chiabotto P, Gennari F, Cortese M G, Canavese F, de Sanctis C
Division of Pediatric Endocrinology (Unit of Pediatric Andrology), Regina Margherita Children's Hospital of Turin, Italy.
J Urol. 1997 May;157(5):1898-901.
We investigated the efficacy of early gonadotropin treatment of cryptorchidism for promoting testicular descent and ameliorating testicular histology.
We treated 319 cryptorchid testes in 281 boys 4 months to 3 years old with luteinizing hormone-releasing hormone and human chorionic gonadotropin sequential therapy. Surgery was done on the 207 testes that did not respond to medical treatment. Microscopic biopsies were performed in 134 of these 207 testes. Histological findings were compared to those of 30 cryptorchid testes in boys younger than 1 year who underwent surgery without previous hormonal treatment.
Combined luteinizing hormone-releasing hormone and human chorionic gonadotropin treatment induced scrotal descent of a percentage of cryptorchid testes depending on clinical position. Therapeutic success was greater when testes were in a lower position and results were not age dependent. Hormonal treatment of cryptorchidism during the first year of life stimulated spermatogonia maturation.
When administered at the end of age 6 months, hormonal treatment can be considered an effective and timely substitution for gonadotropin and testosterone insufficiency in cryptorchid infants. Therefore, we recommend this therapeutic procedure combined with surgery in the first year of life.
我们研究了早期促性腺激素治疗隐睾症促进睾丸下降及改善睾丸组织学的疗效。
我们对281名4个月至3岁男孩的319个隐睾进行了促黄体生成素释放激素和人绒毛膜促性腺激素序贯治疗。对207个对药物治疗无反应的睾丸进行了手术。在这207个睾丸中的134个进行了显微镜活检。将组织学结果与1岁以下未接受过激素治疗而接受手术的男孩的30个隐睾的结果进行比较。
促黄体生成素释放激素和人绒毛膜促性腺激素联合治疗可使一定比例的隐睾下降至阴囊，下降比例取决于临床位置。睾丸位置较低时治疗成功率更高，且结果与年龄无关。1岁以内隐睾症的激素治疗可刺激精原细胞成熟。
6个月龄末给予激素治疗，可被认为是对隐睾婴儿促性腺激素和睾酮不足的有效且及时的替代治疗。因此，我们建议在1岁时将这种治疗方法与手术相结合。
