Abstract
250 prepubertal boys were treated with LHRH nasal spray (HOE 471) 400 ug t.i.d.; 28 days in dbpc study. Whenever a 2nd Rx course proved unsuccessful after a 4wk interval, orchidopexy was performed.
Complete descent: group (gr) a (age 1-2 yrs, 37 boys) 4/41 testes (10%); gr b (age 2-6 yrs, 85 boys) 16/97 testes (16%) gr c (age 6-12 yrs, 91 boys) 48/118 testes (40%). 8 testes descended during placebo Rx. 30 testes needed 2 Rx courses. Relapse in 9 testes. An additional Rx course successful in 5 testes.
Surgical findings in 139 boys: Passed through the inguinal canal but obstructed with processus vaginalis closed or narrow canal: gr a: 40%; gr b, c: 65%. Wide open processus vaginalis with 50% major epididymal deformities: gr a: 40%; gr b, c: 27%. No testes: gr a: 16%; gr b, c: 8%.
Hormonal data: Before Rx: Testosterone(T) response to 1500 U HCG i.m. (gr a>gr b>gr c; p < 0,05) was similar in all groups compared to age matched controle (amc) n=61. Basal LH/FSH values and only the LH response to LHRH 50 ug i.v. were higher in gr a-c compared to amc (p≦0,05). After Rx: LH response decreased only in gr a, FSH response decreased in all groups, but only significantly in b and c (p < 0,05). No change in basal T values b̄ and ā Rx in gr a-c. No hormonal differences were found between uni- and bilateral cryptorchidism nor in success and failure groups.
We conclude that the major anatomical abnormalities and lowest success rate to hormonal Rx were found in gr a (1-2 yrs). Our hormonal data do not support the theory that the mode of action of LHRH Rx is thru activation of the pituitary gonadal axis.
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De Muinck Kelzer, S., Hazebroek, F., Drop, S. et al. 12 A DOUBLE BLIND PLACEBO CONTROLLED (dbpc) STUDY OF LHRH TREATMENT OP UNI-& BILATERAL CRYPTORCHIDISM. Pediatr Res 19, 605 (1985). https://doi.org/10.1203/00006450-198506000-00032
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DOI: https://doi.org/10.1203/00006450-198506000-00032