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European Journal of Pediatrics

, Volume 152, Supplement 2, pp S38–S42 | Cite as

The behavior of epididymis, processus vaginalis and testicular descent in cryptorchid boys treated with buserelin

  • Domingos TG Bica
  • Faruk Hadziselimovic
Cryptorchidism and Male Pseudo-Hermaphroditism

Abstract

This randomized double-blind placebo-controlled study was initiated to analyze the behavior of epididymis, processus vaginalis and testicular descent in cryptorchid boys treated with a low dose (20 μg) of a luteinizing hormone-releasing hormone analogue (Buserelin), administered daily, as a nasal spray, for a short period (28 days). Fifty-nine true cryptorchid boys were randomly assigned to 3 groups: buserelin, treatment [22], surgical treatment [18] or placebo control group [19]. The 3 groups of patients were similar before treatment in regard to testicular position, chronological and bone age, height and weight, luteinizing hormone, follicle-stimulating hormone, testosterone, penile size and the volume of the contralateral descended testis. None of the patients had retractile testes. Buserelin significantly induced testicular descent compared to the boys treated with a placebo (P<0.01). A normal epididymis was found more often in boys with successful descent (P<0.003). A closed processus vaginalis was also more frequently observed in the group treated with buserelin than in surgically treated one (P<0.05). In conclusion, buserelin was capable of inducing testicular descent besides provoking further development of the epididymis and closing the processus vaginalis.

Key words

Buserelin acetate Cryptorchism Epididymis Processus vaginalis Double-blind method 

References

  1. 1.
    Bedford JM (1978) Anatomical evidence for the epididymis as the prime mover in the evolution of the scrotum. Am J Anat 152:483–507PubMedGoogle Scholar
  2. 2.
    Bica DTG, Hadziselimovic F (1992) Buserelin treatment of cryptorchidism: a randomized, double-blind, placebo-controlled study. J Urol 148:617–621PubMedGoogle Scholar
  3. 3.
    Christiansen P, Muller J, Buhl S, Hansen OR, Hobolth N, Jacobsen BB, Jorgensen PH, Kastrup KW, Nielsen K, Nielsen LB, Pedersen-Bjergaard L, Petersen KE, Petersen SA, Thamdrup E, Thisted E, Tranebjoerg L, Skakkebaek NE (1988) Treatment of cryptorchidism with human chorionic gonadotropin or gonadotropin releasing hormone. A double-blind controlled study of 243 boys. Horm, Res 30:187–192Google Scholar
  4. 4.
    de Muinck Keizer-Schrama SM, Hazebroek FW, Matroos AW, Drop SL, Molenaar JC, Visser HK (1986) Double-blind, lacebo-controlled study of luteinizing hormone-releasing hormone nasal spray treatment of undescended testes. Lancet 1:876–880PubMedGoogle Scholar
  5. 5.
    Elder JS (1988) The undescended testis. Hormonal and surgical management. Surg Clin N Am 68:983–1005PubMedGoogle Scholar
  6. 6.
    Gill B, Kogan S, Starr S, Reda E, Levitt S (1989) Significance of epididymal and ductal anomalies associated with testicular maldescent. J Urol 142:556–558PubMedGoogle Scholar
  7. 7.
    Hadziselimovic F, Herzog B, Kruslin E (1978) The morphological background of estrogen-induced cryptorchidism in the mouse. Folia Anat Jugos 8:63–73Google Scholar
  8. 8.
    Hadziselimovic F, Girard J, Herzog B (1984) Four years' experience with a combined hormone therapy of cryptorchidism Z Kinderchir 39:324–327PubMedGoogle Scholar
  9. 9.
    Hadziselimovic F, Herzog B, Buser M (1987) Development of cryptorchid testes. Eur J Ped [Suppl. 2] 146:S8-S12PubMedGoogle Scholar
  10. 10.
    Hadziselimovic F, Herzog B (1990) Hodenerkrankungen im Kindesalter. Hippokrates Verlag, StuttgartGoogle Scholar
  11. 11.
    Hagberg S, Westphal O (1987) Results of combined hormonal and surgical treatment for undescended testis in boys under 3 years of age. A randomized study. Eur J Ped [Suppl 2] 146:S38-S39Google Scholar
  12. 12.
    Happ J, Kallmann F, Krawehl C (1975) Intranasal GnRH therapy of maldescended testes. Horm Metab Res 7:440–441PubMedGoogle Scholar
  13. 13.
    Heath AL, Man DW, Eckestein HB (1984) Epididymal abnormalities associated with maldescent of the testis. J Ped Surg 19:47–49Google Scholar
  14. 14.
    Hutson JM, Watts LM, Montalto J, Greco S (1990) Both gonadotropin and testosterone fail to reverse estrogen-induced cryptorchidism in fetal mice: further evidence for nonandrogenic control of testicular descent in the fetus. Ped Surg Int 5:13–18Google Scholar
  15. 15.
    Illig R, Kollmann F, Borkenstein M, Kuber W, Exner GW, Keller K, Lunglmayr G, Prader A (1977) Treatment of cryptorchidism by intranasal synthetic luteinizing hormone-releasing hormone. Results of a collaborative double-blind study. Lancet 2:518–520PubMedGoogle Scholar
  16. 16.
    Koff WJ, Scaletscky R (1990) Malformations of the epididymis in undescended testis. J Urol 143:340–343PubMedGoogle Scholar
  17. 17.
    Marshall FF, Shermeta DW (1979) Epididymal abnormalities associated with undescended testis. J Urol 121:340–343Google Scholar
  18. 18.
    Mininberg DT, Schlossberg S (1983) The role of the epididymis in testicular descent. J Urol 129:1207–1208PubMedGoogle Scholar
  19. 19.
    Rosenmerkel JF (1820) Über die Radikalkur des in der Weiche liegenden Testikels bei nicht erfolgtem Descensus desselben. J Lindaver, MunichGoogle Scholar
  20. 20.
    Swift PGF, Klidjian AM, Johnstone JMS (1984) A double blind, controlled study of luteinizing hormone-releasing hormone (LHRH) in the management of undescended testis Ped Res 18:1218, Abstract 72Google Scholar
  21. 21.
    Waldschmidt J, el-Dessouky M, Priefer A (1987) Therapeutic results in cryptorchidism after combination therapy with LH-RH nasal spray and HCG. Eur J Ped [Suppl. 2] 146:S31-S34Google Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • Domingos TG Bica
    • 1
  • Faruk Hadziselimovic
    • 2
  1. 1.Department of Pediatric SurgeryFederal University Children's Hospital in Rio de JaneiroRio de JaneiroBrazil
  2. 2.Basler Children's HospitalUniversity ClinicsBaselSwitzerland

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