Gonadotropin Therapy for the Undescended Testis

Abstract

Intensive research during the last 15 years has revolutionized our knowledge about pathogenesis and therapy of testicular maldescent. Today we know that cryptorchidism is not a uniform disorder but a syndrome, caused by a variety of conditions. The role of mechanical obstacles hampering the descent of the gonads increasingly gives way to other etiological factors. The significance of primary malformations is more clearly recognized. Evidence has, however, slowly emerged that in numerous cases initially there is an endocrine disturbance which causes the non-descent. Canlorbe et al. (1974) were the first to show the diminished LH-secretion of the infantile hypophysis resulting in an insufficient testosterone production. The morphologic correlate for this impairment has been demonstrated by Hadžiselimović et al. (1975), and Hadžiselimović and Herzog (1976). Already these discoveries suggest the rationale for treatment. If deficient LH-secretion causes maldescent then administration of preparation with LH-activity, i.e. HCG, corresponds to true replacement therapy.