[Hormonal treatment of undescended testis]

Failure of the testes to descend is probably mostly due to dysfunction of the hypothalamo-pituitary-testis axis. The primary treatment of testicular non descent should therefore be pharmacological in the form of HCG injections or LH-RH intranasally. Contraindications for hormonal therapy are coexistent inguinal hernia or hydrocele testis or previous inguinal operations. HCG and LH-RH treatment lead to testicular descent with about the same frequency, 20-50% in boys above five years of age, whereas HCG therapy before this age results in 10-20% success only. Reversible androgenic side effects are described in approximately 30% following HCG treatment, but only limited side effects are seen in less than 10% after LH-RH therapy. Because of the non-invasive mode of administration, the good response to treatment in the age of 2-5 years and the very limited side effects, LH-RH is recommended as the primary treatment of testicular nondescent.