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Published in: European Journal of Pediatrics 1/2013

01-01-2013 | Review

The controversy regarding the need for hormonal treatment in boys with unilateral cryptorchidism goes on: a review of the literature

Authors: Barbara Ludwikowski, Ricardo González

Published in: European Journal of Pediatrics | Issue 1/2013

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Abstract

Hormonal treatment for unilateral undescended testes continues to be recommended in some countries. We reviewed the literature in favor and against this recommendation. Since the paternity rate of men with a history of unilateral undescended testes only treated with surgery is normal, the effectiveness of hormonal treatment to produce testicular descent is low, the cost is considerable, and there are potential adverse effects, hormonal treatment for boys with unilateral undescended testes should no longer be recommended.
Literature
1.
go back to reference Atkinson PM (1975) A follow-up study of surgically treated cryptorchid patients. J Pediatr Surg 10:115–119PubMedCrossRef Atkinson PM (1975) A follow-up study of surgically treated cryptorchid patients. J Pediatr Surg 10:115–119PubMedCrossRef
2.
go back to reference Barthold JS (2008) Undescended testis: current theories of etiology. Curr Opin Urol 18(4):395–400PubMedCrossRef Barthold JS (2008) Undescended testis: current theories of etiology. Curr Opin Urol 18(4):395–400PubMedCrossRef
3.
go back to reference Barthold JS, Manson J, Regan V, Si X, Hassink SG, Coughlin MT, Lee PA (2004) Reproductive hormone levels in infants with cryptorchidism during postnatal activation of the pituitary-testicular axis. J Urol 172:1736–1741PubMedCrossRef Barthold JS, Manson J, Regan V, Si X, Hassink SG, Coughlin MT, Lee PA (2004) Reproductive hormone levels in infants with cryptorchidism during postnatal activation of the pituitary-testicular axis. J Urol 172:1736–1741PubMedCrossRef
4.
go back to reference Biers SM, Malone PS (2010) A critical appraisal of the evidence for improved fertility indices in undescended testes after gonadotrophin-releasing hormone therapy and orchidopexy. J Pediatr Urol 6:239–246PubMedCrossRef Biers SM, Malone PS (2010) A critical appraisal of the evidence for improved fertility indices in undescended testes after gonadotrophin-releasing hormone therapy and orchidopexy. J Pediatr Urol 6:239–246PubMedCrossRef
5.
go back to reference Borgward TG (2004) Bernhard Schapiro (1888-1966): Talmudic scholar-andrologist-pioneer of hormonal Treatment for cryptorchidism. Wurzbg Medizinhist Mitt 23:393–411 Borgward TG (2004) Bernhard Schapiro (1888-1966): Talmudic scholar-andrologist-pioneer of hormonal Treatment for cryptorchidism. Wurzbg Medizinhist Mitt 23:393–411
7.
go back to reference CendronM KMA, Huff DS, Koop CE, Snyder HM 3rd, Duckett JW (1989) Cryptorchidism, orchiopexy and infertility: a critical long-term retrospective analysis. J Urol 142:559–562 CendronM KMA, Huff DS, Koop CE, Snyder HM 3rd, Duckett JW (1989) Cryptorchidism, orchiopexy and infertility: a critical long-term retrospective analysis. J Urol 142:559–562
8.
go back to reference Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, Haugen TB, Kruger T, Wang C, Mbizvo MT, Vogelsong KM (2010) World Health Organization reference values for human semen characteristics. Hum Reprod Update 16:231–245PubMedCrossRef Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, Haugen TB, Kruger T, Wang C, Mbizvo MT, Vogelsong KM (2010) World Health Organization reference values for human semen characteristics. Hum Reprod Update 16:231–245PubMedCrossRef
9.
go back to reference Cortes D, Thorup J, Lindenberg S, Visfeldt J (2003) Infertility despite surgery for cryptorchidism in childhood can be classified by patients with normal or elevated follicle-stimulating hormone and identified at orchidopexy. BJU Int 91:670–674PubMedCrossRef Cortes D, Thorup J, Lindenberg S, Visfeldt J (2003) Infertility despite surgery for cryptorchidism in childhood can be classified by patients with normal or elevated follicle-stimulating hormone and identified at orchidopexy. BJU Int 91:670–674PubMedCrossRef
10.
go back to reference Cortes D, Thorup J, Visfeldt J (2000) Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism. J Urol 163:1290–1292PubMedCrossRef Cortes D, Thorup J, Visfeldt J (2000) Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism. J Urol 163:1290–1292PubMedCrossRef
11.
go back to reference Cortes D, Thorup JM, Visfeldt J (2001) Cryptorchidism: aspects of fertility and neoplasms. A study including data of 1335 consecutive boys who underwent testicular biopsy simultaneously with surgery for cryptorchidism. Horm Res 55:21–27PubMedCrossRef Cortes D, Thorup JM, Visfeldt J (2001) Cryptorchidism: aspects of fertility and neoplasms. A study including data of 1335 consecutive boys who underwent testicular biopsy simultaneously with surgery for cryptorchidism. Horm Res 55:21–27PubMedCrossRef
12.
go back to reference De Muinck Keizer-Schrama SM, Hazebroek FW, Drop SL, Degenhart HJ, Molenaar JC, Visser HK (1988) Hormonal evaluation of boys born with undescended testes during their first year of life. J Clin Endocrinol Metab 66:159–164PubMedCrossRef De Muinck Keizer-Schrama SM, Hazebroek FW, Drop SL, Degenhart HJ, Molenaar JC, Visser HK (1988) Hormonal evaluation of boys born with undescended testes during their first year of life. J Clin Endocrinol Metab 66:159–164PubMedCrossRef
13.
go back to reference Demirbilek S, Atayurt HF, Celik N, Aydin G (1997) Does treatment with human chorionic gonadotropin induce reversible changes in undescended testes in boys? Pediatr Surg Int 12:591–594PubMedCrossRef Demirbilek S, Atayurt HF, Celik N, Aydin G (1997) Does treatment with human chorionic gonadotropin induce reversible changes in undescended testes in boys? Pediatr Surg Int 12:591–594PubMedCrossRef
14.
go back to reference Dunkel L, Taskinen S, Hovatta O, Tilly JL, Wikström S (1997) Germ cell apoptosis after treatment of cryptorchidism with human chorionic gonadotropin is associated with impaired reproductive function in the adult. J Clin Invest 100:2341–2346PubMedCrossRef Dunkel L, Taskinen S, Hovatta O, Tilly JL, Wikström S (1997) Germ cell apoptosis after treatment of cryptorchidism with human chorionic gonadotropin is associated with impaired reproductive function in the adult. J Clin Invest 100:2341–2346PubMedCrossRef
15.
go back to reference Fallon B, Kennedy TJ (1985) Long-term follow-up of fertility in cryptorchid patients. Urology 25:502–504PubMedCrossRef Fallon B, Kennedy TJ (1985) Long-term follow-up of fertility in cryptorchid patients. Urology 25:502–504PubMedCrossRef
16.
go back to reference Fanconi S, Reinberg O, Gapany G, Meyrat BJ, Frey F, Vaudaux B, Di Bernardo S, Boulos T, Sekarski S, Spehrs-Ciaffi V, Jeannet PY (2008) Pediatrics. Rev Med Suisse 4:61–66PubMed Fanconi S, Reinberg O, Gapany G, Meyrat BJ, Frey F, Vaudaux B, Di Bernardo S, Boulos T, Sekarski S, Spehrs-Ciaffi V, Jeannet PY (2008) Pediatrics. Rev Med Suisse 4:61–66PubMed
17.
go back to reference Forest MG, Sizonenko PC, Cathiard AM, Bertrand J (1974) Hypophyso-gonadal function in humans during the first year of life. 1. Evidence for testicular activity in early infancy. J Clin Invest 53:819–828PubMedCrossRef Forest MG, Sizonenko PC, Cathiard AM, Bertrand J (1974) Hypophyso-gonadal function in humans during the first year of life. 1. Evidence for testicular activity in early infancy. J Clin Invest 53:819–828PubMedCrossRef
18.
go back to reference Hadziselimovic F, Emmons LR, Buser MW (2004) A diminished postnatal surge of Ad spermatogonia in cryptorchid infants is additional evidence for hypogonadotropic hypogonadism. Swiss Med Wkly 134:381–384PubMed Hadziselimovic F, Emmons LR, Buser MW (2004) A diminished postnatal surge of Ad spermatogonia in cryptorchid infants is additional evidence for hypogonadotropic hypogonadism. Swiss Med Wkly 134:381–384PubMed
19.
go back to reference Hadziselimovic F, Herzog B (2001) Importance of early postnatal germ cell maturation for fertility of cryptorchid males. Horm Res 55:6–10PubMedCrossRef Hadziselimovic F, Herzog B (2001) Importance of early postnatal germ cell maturation for fertility of cryptorchid males. Horm Res 55:6–10PubMedCrossRef
20.
go back to reference Hadziselimovic F, Hocht B, Herzog B, Buser MW (2007) Infertility in cryptorchidism is linked to the stage of germ cell development at orchidopexy. Horm Res 68:46–52PubMedCrossRef Hadziselimovic F, Hocht B, Herzog B, Buser MW (2007) Infertility in cryptorchidism is linked to the stage of germ cell development at orchidopexy. Horm Res 68:46–52PubMedCrossRef
21.
go back to reference Jallouli M, Rebai T, Abid N, Bendhaou M, Kassis M, Mhiri R (2009) Neoadjuvant gonadotropin-releasing hormone therapy before surgery and effect on fertility index in unilateral undescended testes: a prospective randomized trial. Urology 73:1251–1254PubMedCrossRef Jallouli M, Rebai T, Abid N, Bendhaou M, Kassis M, Mhiri R (2009) Neoadjuvant gonadotropin-releasing hormone therapy before surgery and effect on fertility index in unilateral undescended testes: a prospective randomized trial. Urology 73:1251–1254PubMedCrossRef
22.
go back to reference Job JC, Toublanc JE, Chaussain JL, Gendrel D, Roger M, Canlorbe P (1987) The pituitary-gonadal axis in cryptorchid infants and children. Eur J Pediatr 146:S2–S5PubMedCrossRef Job JC, Toublanc JE, Chaussain JL, Gendrel D, Roger M, Canlorbe P (1987) The pituitary-gonadal axis in cryptorchid infants and children. Eur J Pediatr 146:S2–S5PubMedCrossRef
23.
go back to reference Kollin C, Karpe B, Hesser U, Granholm T, Ritzén EM (2007) Surgical treatment of unilaterally undescended testes: testicular growth after randomization to orchiopexy at age 9 months or 3 years. J Urol 178:1589–1593PubMedCrossRef Kollin C, Karpe B, Hesser U, Granholm T, Ritzén EM (2007) Surgical treatment of unilaterally undescended testes: testicular growth after randomization to orchiopexy at age 9 months or 3 years. J Urol 178:1589–1593PubMedCrossRef
24.
go back to reference Lala R, Matarazzo P, Chiabotto P, de Sanctis C, Canavese F, Hadziselimovic F (1993) Combined therapy with Lhrh and Hcg in cryptorchid infants. Eur J Pediatr 152:S31–S33PubMedCrossRef Lala R, Matarazzo P, Chiabotto P, de Sanctis C, Canavese F, Hadziselimovic F (1993) Combined therapy with Lhrh and Hcg in cryptorchid infants. Eur J Pediatr 152:S31–S33PubMedCrossRef
25.
go back to reference Lee PA, O'Leary LA, Songer NJ, Coughlin MT, Bellinger MF, LaPorte RE (1996) Paternity after unilateral cryptorchidism: a controlled study. Pediatrics 98:676–679PubMed Lee PA, O'Leary LA, Songer NJ, Coughlin MT, Bellinger MF, LaPorte RE (1996) Paternity after unilateral cryptorchidism: a controlled study. Pediatrics 98:676–679PubMed
26.
go back to reference Lee PA, Coughlin MT (2002) The single testis: paternity after presentation as unilateral cryptorchidism. J Urol 168:1680–1682PubMedCrossRef Lee PA, Coughlin MT (2002) The single testis: paternity after presentation as unilateral cryptorchidism. J Urol 168:1680–1682PubMedCrossRef
27.
go back to reference Lee PA, Coughlin MT, Bellinger MF (2000) Paternity and hormone levels after unilateral cryptorchidism: association with pretreatment testicular location. J Urol 164:1697–1701PubMedCrossRef Lee PA, Coughlin MT, Bellinger MF (2000) Paternity and hormone levels after unilateral cryptorchidism: association with pretreatment testicular location. J Urol 164:1697–1701PubMedCrossRef
28.
go back to reference Marchetti F, Bua J, Tornese G, Piras G, Toffol G, Ronfani L, Italian Study Group on Undescended Testes ISGUT (2012) Management of cryptorchidism: a survey of clinical practice in Italy. BMC Pediatr 12(1):4PubMedCrossRef Marchetti F, Bua J, Tornese G, Piras G, Toffol G, Ronfani L, Italian Study Group on Undescended Testes ISGUT (2012) Management of cryptorchidism: a survey of clinical practice in Italy. BMC Pediatr 12(1):4PubMedCrossRef
29.
go back to reference Mathers MJ, Sperling H, Rübben H, Roth S (2009) Hodenhochstand: diagnostik, therapie und langfristige konsequenzen. Dtsch Arztebl Int 106:527–532PubMed Mathers MJ, Sperling H, Rübben H, Roth S (2009) Hodenhochstand: diagnostik, therapie und langfristige konsequenzen. Dtsch Arztebl Int 106:527–532PubMed
30.
go back to reference Miller KD, Coughlin MT, Lee PA (2001) Fertility after unilateral cryptorchidism. Paternity, time to conception, pretreatment testicular location and size, hormone and sperm parameters. Horm Res 55:249–253PubMedCrossRef Miller KD, Coughlin MT, Lee PA (2001) Fertility after unilateral cryptorchidism. Paternity, time to conception, pretreatment testicular location and size, hormone and sperm parameters. Horm Res 55:249–253PubMedCrossRef
31.
go back to reference Niederberger C, Joyce GF, Wise M, Meacham RB (2007) Male infertility. In: MS Litwin, CS Saigal (eds) Urologic diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. US Government Printing Office, Washington, DC, NIH Publication No. 07-5512, 2007, pp 461-481 Niederberger C, Joyce GF, Wise M, Meacham RB (2007) Male infertility. In: MS Litwin, CS Saigal (eds) Urologic diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. US Government Printing Office, Washington, DC, NIH Publication No. 07-5512, 2007, pp 461-481
32.
go back to reference Paasch U, Thieme C, Grunewald S, Glander HJ (2004) Electronic data base systems support the evaluation of male infertility factors, example cryptorchidism. Urol Int 72:154–161PubMedCrossRef Paasch U, Thieme C, Grunewald S, Glander HJ (2004) Electronic data base systems support the evaluation of male infertility factors, example cryptorchidism. Urol Int 72:154–161PubMedCrossRef
33.
go back to reference Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O (2007) Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 356:1835–1841PubMedCrossRef Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O (2007) Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 356:1835–1841PubMedCrossRef
34.
go back to reference Pyörälä S, Huttunen NP, Uhari M (1995) A review and meta-analysis of hormonal treatment of cryptorchidism. J Clin Endocrinol Metab 80:2795–2799PubMedCrossRef Pyörälä S, Huttunen NP, Uhari M (1995) A review and meta-analysis of hormonal treatment of cryptorchidism. J Clin Endocrinol Metab 80:2795–2799PubMedCrossRef
35.
go back to reference Raivio T, Toppar J, Kaleva M, Virtanen H, Haavisto AM, Dunke L, Jänne OA (2003) Serum androgen bioactivity in cryptorchid and noncryptorchid boys during the postnatal reproductive hormone surge. J Clin Endocrinol Metab 88:2597–2599PubMedCrossRef Raivio T, Toppar J, Kaleva M, Virtanen H, Haavisto AM, Dunke L, Jänne OA (2003) Serum androgen bioactivity in cryptorchid and noncryptorchid boys during the postnatal reproductive hormone surge. J Clin Endocrinol Metab 88:2597–2599PubMedCrossRef
36.
go back to reference Retief PJ (1977) Fertility in undescended testes. S Afr Med J 52:610–613PubMed Retief PJ (1977) Fertility in undescended testes. S Afr Med J 52:610–613PubMed
37.
go back to reference Ritzén EM, Bergh A, Bjerknes R, Christiansen P, Cortes D, Haugen SE, Jörgensen N, Kollin C, Lindah lS, Lackgren G, Main KM, Nordenskjöld A, Rajpert-De Meyts E, Söder O, Taskinen S, Thorsson A, Thorup J, Toppari J, Virtanen H (2007) Nordic consensus on treatment of undescended testes. Acta Paediatr 96:638–643PubMedCrossRef Ritzén EM, Bergh A, Bjerknes R, Christiansen P, Cortes D, Haugen SE, Jörgensen N, Kollin C, Lindah lS, Lackgren G, Main KM, Nordenskjöld A, Rajpert-De Meyts E, Söder O, Taskinen S, Thorsson A, Thorup J, Toppari J, Virtanen H (2007) Nordic consensus on treatment of undescended testes. Acta Paediatr 96:638–643PubMedCrossRef
38.
go back to reference Schwentner C, Oswald J, Kreczy A, Lunacek A, Bartsch B, Deibl M, Radmayr C (2005) Neoadjuvant gonadotropin-releasing hormone therapy before surgery may improve the fertility index in undescended testes: a prospective randomized trial. J Urol 173:974–977PubMedCrossRef Schwentner C, Oswald J, Kreczy A, Lunacek A, Bartsch B, Deibl M, Radmayr C (2005) Neoadjuvant gonadotropin-releasing hormone therapy before surgery may improve the fertility index in undescended testes: a prospective randomized trial. J Urol 173:974–977PubMedCrossRef
39.
go back to reference Suomi AM, Main KM, Kaleva M, Schmidt IM, Chellakooty M, Virtanen HE, Boisen KA, Damgaard IN, Kai CM, Skakkebaek NE, Toppari J (2006) Hormonal changes in 3-month-old cryptorchid boys. J Clin Endocrinol Metab 91:953–958PubMedCrossRef Suomi AM, Main KM, Kaleva M, Schmidt IM, Chellakooty M, Virtanen HE, Boisen KA, Damgaard IN, Kai CM, Skakkebaek NE, Toppari J (2006) Hormonal changes in 3-month-old cryptorchid boys. J Clin Endocrinol Metab 91:953–958PubMedCrossRef
40.
go back to reference Thorsson AV, Christiansen P, Ritzén M (2007) Efficacy and safety of hormonal treatment of cryptorchidism: current state of the art. Acta Paediatr 96:628–630PubMedCrossRef Thorsson AV, Christiansen P, Ritzén M (2007) Efficacy and safety of hormonal treatment of cryptorchidism: current state of the art. Acta Paediatr 96:628–630PubMedCrossRef
41.
go back to reference Virtanen HE, Toppari J (2008) Epidemiology and pathogenesis of cryptorchidism. Hum Reprod Updat 14:49–58CrossRef Virtanen HE, Toppari J (2008) Epidemiology and pathogenesis of cryptorchidism. Hum Reprod Updat 14:49–58CrossRef
Metadata
Title
The controversy regarding the need for hormonal treatment in boys with unilateral cryptorchidism goes on: a review of the literature
Authors
Barbara Ludwikowski
Ricardo González
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 1/2013
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-012-1711-y

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