European Journal of Pediatrics

, Volume 139, Issue 4, pp 275–279 | Cite as

Undescended testes: Treatment with gonadotropin

  • J. R. Bierich
Symposium Undescended Testes April 24, 1982, Rotterdam, The Netherlands Organized by the Foundation for Urological Research (SUWO), Rotterdam


The therapeutic success of treatment of testicular maldescent must be judged according to 2 parameters,-I. occurrence of descent, II. fertility.

Ad I. Indication for hCG-treatment is always given unless an unequivocal indication for operation exists, i.e. ectopias, accompanying hernias, retention after herniotomy and advanced puberty. The optimal time for treatment is the second year of life. The large European statistics which include the prescrotal but not the retractile testes, unanimously show success rates of 50–55%. In the largest American series which does not include prescrotal testicles, descent was observed in 40% of the bilateral and in 30% of the unilateral cases. Analyzing those cases which did not respond to hormones but had to be operated, in the majority of cases ectopic, not dystopic gonads were found.

Ad II. Infertility in testicular maldescent can have two reasons, 1. congenital anomalies of the primordium, 2. acquired damages due to the malposition. The few large prospective studies at hand show fertility in the majority of cases with descent after hCG, but in the minority of those coming down only after additional operation. Obviously the latter group represents a negative selection. Unilateral cases had a higher fertility rate than bilateral ones.

Key words

Dystopias Ectopias Inguinal testes Prescrotal testes Testicular maldescent hCG Fertility 


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  1. 1.
    Attanasio A, Jendricke K, Bulle G, Flach A, Reisert I, Gupta D, Bierich JR (1974) Cryptorchidism: clinical, hormonal and histological studies. Acta Endocrinol (Copenhagen) [Suppl] 184:51Google Scholar
  2. 2.
    Baetgen D (1970) Behandlungsergebnisse des Testis mobilis und der ein- und beidseitigen Retentio testis inguinalis mit Primogonyl. Med Welt I:313Google Scholar
  3. 3.
    Bergadá C (1979) Clinical treatment of cryptorchidism. In: Bierich JR, Giarola A (eds) Cryptorchidism. Academic Press, LondonGoogle Scholar
  4. 4.
    Bergadá C, Mancini RE (1973) Effect of gonadotropins in the induction of spermatogenesis in human prepubertal testis. J Clin Endocrinol Metab 37:935Google Scholar
  5. 5.
    Bergstand CG, Quist O (1961) Treatment of undescended testes with human gonadotropin. Acta Paediat 37:231Google Scholar
  6. 5a.
    Bierich JR (1977) Treatment by human chorionic gonadotrophin in maldescended tests. In: Bierich JR, Rager K, Ranke MB (eds) Maldescensus testis. Urban & Schwarzenberg, München Wien BaltimoreGoogle Scholar
  7. 6.
    Brambilla F, Zanoboni A (1968) Nuova terapia del criptorchidismo: la gonadotropina umana della menopausa. Folia Endocrinol 21:270Google Scholar
  8. 7.
    Brambilla F, Zanoboni A (1969) L'Associazione gonadotropina umana delle menopausa e gonadotropina corionica nel trattamento del criptorchidismo. Folia Endocrinol 22:104Google Scholar
  9. 8.
    Buemann B, Henriksen H, Villumsen AL, Westh A, Zachau-Christiansen B (1961) Incidence of undescended testis in the newborn. Acta Chir Scand 283:289Google Scholar
  10. 9.
    Bulle G, Attanasio A, Rager K (1975) Klinische Befunde zur Behandlung des Hodenhochstandes. Monatschr Kinderheilk 123:354Google Scholar
  11. 10.
    Cernea R (1951) Zur Hormonbehandlung des Kryptorchismus. Hippokrates 22:241Google Scholar
  12. 11.
    Charny ChW, Wolgin W (1956) The management of cryptorchidism. Surg Gyn Obst 102:177Google Scholar
  13. 12.
    Charny ChW, Wolgin W (1957) Cryptorchidism. Cassell, LondonGoogle Scholar
  14. 13.
    Deming C (1952) The evaluation of hormonal therapy in cryptorchidism. J Urol 68:354Google Scholar
  15. 14.
    Doepfmer R (1964) Frequency of dystopias of the testis (cryptorchidism) in adults and the importance of unilateral dystopia for fertility. Symp Int Fertil Assoc, AmsterdamGoogle Scholar
  16. 15.
    Doepfmer R, Nienaber W (1964) Die einseitige Hodenektopie. Muench Med Wochenschr 106:2096Google Scholar
  17. 15a.
    Editorial (1958) Medical Officer 100:379Google Scholar
  18. 16.
    Giarola A, Agostini G (1979) Undescended testis and male fertility. In: Bierich JR, Giarola A (eds) Cryptorchidism. Academic Press, LondonGoogle Scholar
  19. 17.
    Gross RE, Jewett TC (1956) Surgical experiences from 1222 operations for undescended testis. JAMA 160:634Google Scholar
  20. 18.
    Hand JR (1957) Treatment of undescended testis and its complications. JAMA 164Google Scholar
  21. 19.
    Hecker WChr, Braren F (1958) Zur Therapie der Hodenretention unter besonderer Berücksichtigung des Zeitfktors. Ärztl Wochenschr 13:83Google Scholar
  22. 20.
    Hecker WChr, Daum R, Hienz HA (1964) Beitrag zum Kryptorchismusproblem unter besonderer Berücksichtigung der Ergebnisse von Hodenbiopsien. Dtsch Med Wochenschr 89:2177Google Scholar
  23. 21.
    Hinman F (1955) Optimum time for orchidopexy in cryptorchidism. Fertil Steril 6:206Google Scholar
  24. 22.
    Knorr D (1970) Clinical treatment of cryptorchidism. In: Bierich JR, Giarola A (eds) Cryptorchidism. Academic Press, LondonGoogle Scholar
  25. 23.
    Laron Z, Levy J (1965) Diagnosis, treatment and follow-up of 326 cases as referred as undescended testes. Acta Endocrinol (Copenhagen) [Suppl] 101:14Google Scholar
  26. 24.
    Lowsley (1959) Cit from H Dettmar: Indikation und Zeitpunkt der hormonalen und operativen Behandlung beim Kryptorchismus. Therapiewoche 9:334Google Scholar
  27. 25.
    Mancini RE, Cullen M, Rosemberg E, Lavieri JC, Vilar O, Bergadá C, Andradá JA (1965) Cryptorchid and scrotal human testes. I. Cytological, cytochemical and quantitative studies. J Clin Endocrinol Metab 25:927Google Scholar
  28. 26.
    Nicole R, Spindler B (1964) Prognosis as to fertility following operations for cryptorchism in children. Symp Int Fertil Assoc, AmsterdamGoogle Scholar
  29. 26a.
    Pagliano-Sassi L (1979) Significance and results of medical treatment in cryptorchidism. In: Bierich JR, Giarola A (eds) “Cryptorchidism”. Academic Press, London New York Toronto Sydney San FranciscoGoogle Scholar
  30. 27.
    Raboch J, Zahor Z (1956) Über die Fertilität von Männern mit Kryptorchismus. Schweiz Med Wochenschr 85:1196Google Scholar
  31. 28.
    Richter W, Pröschold M, Butenandt O, Knorr D (1976) Die Fertilität nach HCG-Behandlung des Maldescensus Testis. Klin Wochenschr 54:467Google Scholar
  32. 29.
    Robinson JE, Engle ET (1954) Some observations on the cryptorchid testis. J Urol 71:726Google Scholar
  33. 30.
    Schirren C (1964) The histology of undescended testicle and the spermatogram of hormone-treated and of surgically treated patients. Symp Int Fertil Assoc, AmsterdamGoogle Scholar
  34. 31.
    Scorer CG (1955) Descent of the testicle in the first year of life. Br J Urol 27:374Google Scholar
  35. 32.
    Scott LS (1951) Unilateral cryptorchidism: subsequent effects on fertility. J Reprod Fertil 2:54Google Scholar
  36. 32a.
    Scott LS (1964) Germ cell degeneration subsequent to delayed treatment of cryptorchidism. Sympos Internat Fertil Assoc: “Treatment of testicular maldescent”, 25. 4. 1964, AmsterdamGoogle Scholar
  37. 33.
    Sohval AR, Soffer LJ (1953) Congenital familiar testicular deficiency. Am J Med 14:328–348Google Scholar
  38. 34.
    Tonutti E, Weller O, Schuchardt E, Heinke E (1960) Die männliche Keimdrüse, Thieme-Verlag, StuttgartGoogle Scholar
  39. 35.
    Webster (1959) Cit from H Dettmar: Indikation und Zeitpunkt der hormonalen und operativen Behandlung beim Kryptorchismus. Therapiewoche 9:334Google Scholar
  40. 36.
    Weyeneth R (1956) Quand faut-il opérer un testicule ectopique? Rev Med Suisse Rom 76:654Google Scholar
  41. 37.
    Zamudio-Albescú J (1979) Cryptorchidism and fertility. In: Bierich JR, Giarola A (eds) Cryptorchidism. Academic Press, LondonGoogle Scholar

Copyright information

© Springer-Verlag 1982

Authors and Affiliations

  • J. R. Bierich
    • 1
  1. 1.Univ.-KinderklinikTübingenFederal Republic of Germany

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