EARLY HORMONAL AND SURGICAL-TREATMENT OF CRYPTORCHIDISM

Purpose: We investigated the efficacy of early gonadotropin treatment of cryptorchidism for promoting testicular descent and ameliorating te sticular histology. Materials and Methods: We treated 319 cryptorchid testes in 281 boys 4 months to 3 years old with luteinizing hormone-re leasing hormone and human chorionic gonadotropin sequential therapy. S urgery was done on the 207 testes that did not respond to medical trea tment. Microscopic biopsies were performed in 134 of these 207 testes. Histological findings were compared to those of 30 cryptorchid testes in boys younger than 1 year who underwent surgery without previous ho rmonal treatment. Results: Combined luteinizing hormone-releasing horm one and human chorionic gonadotropin treatment induced scrotal descent of a percentage of cryptorchid testes depending on clinical position. Therapeutic success was greater when testes were in a lower position and results were not age dependent. Hormonal treatment of cryptorchidi sm during the first year of life stimulated spermatogonia maturation. Conclusions: When administered at the end of age 6 months, hormonal tr eatment can be considered an effective and timely substitution for gon adotropin and testosterone insufficiency in cryptorchid infants. There fore, we recommend this therapeutic procedure combined with surgery in the first year of life.