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Hormonal treatment for unilateral inguinal testis: comparison of four different treatments
S Bertelloni1, G I Baroncelli, P Ghirri
1Endocrine Unit, Division of Paediatrics, Santa Chiara Hospital, University of Pisa, Italy. s.bertelloni@clp.med.unipi.it
Background:
Hormonal treatment of cryptorchidism has been used since the 30s, but controversies persist on its efficacy. It is also unclear whether there are differences with the use of different hormonal trials.
Aims:
To evaluate the efficacy of four hormonal treatments on testicular descent in a homogeneous group of cryptorchid boys.
Patients:
155 patients (age 10-48 months) with unilateral inguinal palpable testis were studied.
Methods:
The patients were subdivided into four groups according to hormonal treatment: group 1 = hCG [500 IU/week (if the chronological age was <2 years) or 1,000 IU/week (if the chronological age was >2 years) for 6 weeks]; group 2 = hCG + hMG (hCG as in group 1 + hMG 75 IU/week for 6 weeks); group 3 = GnRH (1,200 microg/daily for 28 days); group 4 = GnRH + hCG (1,200 microg/daily for 28 days + 1,500 IU/week for 3 weeks, respectively). The results were evaluated at the end of the treatment period and 6 months later to exclude temporarily positive results.
Results:
At the end of the hormonal therapy, scrotal testicular descent was present in 30 of 155 boys (success rate 19.3%). Seven testes relapsed during follow-up (23.3%). The long-term success rate was 14.8% (23/155 testes). No significant differences were observed in success rates as well as in relapse rates among the four groups.
Conclusions:
Hormonal therapy induced permanent testicular descent in a minority of young cryptorchid boys with inguinal palpable testis. Similar results were obtained with four different trials.