Endocrinological studies in undescended testes

Area of Science:

• Pediatric Endocrinology
• Reproductive Endocrinology
• Andrology

Background:

• Undescended testis (cryptorchidism) is a common congenital anomaly in boys.
• Potential disturbances in the pituitary-gonadal axis are suspected in cryptorchidism.
• Early identification of endocrine dysfunction is crucial for timely intervention.

Purpose of the Study:

• To investigate urinary excretion of testosterone, delta4-androstenedione, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in boys with undescended testes.
• To correlate hormonal excretion patterns with chronological age, bone age, and sexual maturation stage.
• To assess pituitary-gonadal function in relation to cryptorchidism severity and age.

Main Methods:

• Cross-sectional study of 168 boys aged 2.5–16.8 years with unilateral or bilateral testicular maldescent.
• Measurement of urinary testosterone, delta4-androstenedione, LH, and FSH.
• Analysis of hormonal levels in relation to age, bone age, pubertal stage, and after human chorionic gonadotropin (HCG) stimulation.

Main Results:

• Elevated urinary testosterone excretion in younger boys (<9 years) with undescended testes; delayed pubertal testosterone increase noted.
• Normal testosterone/androstenedione ratio up to 14.9 years, with an increase thereafter.
• Variable LH and FSH excretion patterns observed, with diminished LH in younger bilateral cases and elevated LH/FSH in pubertal unilateral cases.
• Basal testosterone and androstenedione were normal in bilateral anorchia, but LH and FSH were elevated.

Conclusions:

• Pituitary-gonadal function disturbances may be present from early childhood in boys with cryptorchidism.
• Hormonal dysregulation persists throughout pubertal years, varying with the type and severity of undescended testis.
• Findings suggest a potential role for early endocrine assessment in managing cryptorchidism.