EFFECT OF A COMBINED GNRH HCG THERAPY IN BOYS WITH UNDESCENDED TESTICLES - EVALUATED IN RELATION TO TESTICULAR LOCALIZATION WITHIN THE FIRST WEEK AFTER BIRTH/

Among 509 boys referred with undescended testicles, 112 had true undes cended testicles unilaterally and 62 bilaterally. Patients with true u ndescended testicles were offered hormonal treatment unless the condit ion was associated with hernia or previous operations. Boys less than 5 years old were primarily treated with gonadotrophin releasing hormon e (GnRH), while boys more than 5 years old were primarily treated with human chorionic gonadotrophin (hCG). If the effect of the primary tre atment was insufficient the other hormone was given. Testicular descen t was obtained for 64% (23/36) of the intraabdominally located testicl es in boys with bilaterally undescended testicles versus only 14% (3/2 1) in boys with unilaterally undescended testicles (p , .001). Treatin g 1 to 4 years old boys with GnRH resulted in descent in 16 of 95 test icles and secondary treatment with hCG yielded an additional 34, where as secondary treatment of 5 to 13 years old boys with GnRH added only 10 descended testicles to 51 of 101 testicles. Reading the maternity r ecords of 272 of the boys support other studies that testicles may rea scend. Boys with endocrinological or ''surgical'' causes of incomplete testicular descent were relatively more likely to have had one or two undescended testicles during the first postnatal week compared with b oys found to have only retractile testicles (p < .001). Treatment with hormones resulted in descent in 56% of boys whose testicles were both descended within one week after birth. Conversely, only 1 of 20 boys with unilateral testicular undescent postnatally was sufficiently trea ted hormones (p < .001). The hormonal effects in boys with bilaterally undescended testicles at delivery did not differ significantly from b oys with either one or more undescended testicles postnatally. In 35 o f 51 boys (69%) in whom the hormonal effect was insufficient, operatio n revealed a ''surgical cause'' of the incomplete testicular descent.