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A systematic review and meta-analysis of comparative studies assessing the efficacy of luteinizing hormone-releasing hormone therapy for children with cryptorchidism

  • Urology - Review
  • Published:
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Abstract

Purpose

To assess the efficacy of intranasal luteinizing hormone-releasing hormone (LHRH) therapy for cryptorchidism.

Materials and methods

Eligible studies were identified by two reviewers using PubMed, Embase, and Web of Science databases. Primary outcomes were complete testicular descent rate, complete testicular descent rate for nonpalpable testis, and pre-scrotal and inguinal testis. Secondary outcomes included testicular descent with different medicines strategy and a subgroup analysis.

Results

Pooled data including the 1255 undescended testes showed that complete testicular descent rate was 20.9 % in LHRH group versus 5.6 % in the placebo group, which was significantly different [relative risk (RR) 3.94, 95 % confidence interval (CI) 2.14–7.28, P < 0.0001]. There was also a significant difference in the incidence of pre-scrotal and inguinal position testis descent, with 22.8 % in the LHRH group versus 3.6 % in the placebo group (RR 5.79, 95 % CI 2.94–11.39, P < 0.00001). However, side effects were more frequent in the LHRH group (RR 2.61, 95 % CI 1.52–4.49, P = 0.0005). There were no significant differences for nonpalpable testes.

Conclusions

LHRH had significant benefits on testicular descent, particularly for inguinal and pre-scrotal testes, which was also accompanied by temporary slight side effects.

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Abbreviations

LHRH:

Luteinizing hormone-releasing hormone

CO:

Cryptorchidism

RCTs:

Randomized controlled trials

CCT:

Clinical controlled trial

RR:

Relative risk

CI:

Confidence interval

FSH:

Follicle-stimulating hormone

LH:

Luteinizing hormone

CGRP:

Calcitonin gene-related peptide

HCG:

Human chorionic gonadotropin

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Acknowledgments

Dr. Yang was supported by the Prostate Cancer Foundation Young Investigator Award 2013, the National Natural Science Foundation of China (Grants 81300627, 81370855, and 30901484), and the Programs from the Science and Technology Department of Sichuan Province (Grants 2013SZ0006 and 2014JY0219).

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    Authors and Affiliations

    1. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China

      Tao Li, Liang Gao, Peng Chen, Siyuan Bu, Dehong Cao, Lu Yang & Qiang Wei

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    1. Tao Li
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    Correspondence to Lu Yang or Qiang Wei.

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    This article does not contain any studies with human participants or animals performed by any of the authors as this is a meta-analysis.

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    Tao Li and Liang Gao have contributed equally to this work.

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    Li, T., Gao, L., Chen, P. et al. A systematic review and meta-analysis of comparative studies assessing the efficacy of luteinizing hormone-releasing hormone therapy for children with cryptorchidism. Int Urol Nephrol 48, 635–644 (2016). https://doi.org/10.1007/s11255-016-1235-x

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