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Horm Metab Res 2016; 48(05): 318-324
DOI: 10.1055/s-0042-104059
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

The Effectiveness of hCG and LHRH in Boys with Cryptorchidism: A Meta-Analysis of Randomized Controlled Trials

Q. Bu   *
1   Department of Genetics, Northwest Women’s and Children’s Hospital, Xi’an, China
,
Z. Pan   *
2   Department of Clinical Pharmacy, Xi’an Jiaotong University Affiliated Children’s Hospital, Xi’an, China
,
S. Jiang
3   Department of Psychiatry, The University of Illinois at Chicago, Chicago, USA
,
A. Wang
2   Department of Clinical Pharmacy, Xi’an Jiaotong University Affiliated Children’s Hospital, Xi’an, China
,
H. Cheng
2   Department of Clinical Pharmacy, Xi’an Jiaotong University Affiliated Children’s Hospital, Xi’an, China
› Author Affiliations
Further Information

Publication History

received 29 August 2015

accepted after second revision 24 February 2016

Publication Date:
06 April 2016 (online)

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Abstract

To systematically review the efficacy of hCG and LHRH on testicular descent in boys with cryptorchidism, comprehensive search was performed to identify randomized controlled trials (RCTs) in PubMed, EMBASE, the Cochrane Library, Wanfang Database, and China National Knowledge Infrastructure (CNKI) up to March 2014. Outcomes included testicular complete descent rate (TCDR) and cure rate of patients. Study quality was evaluated using the Jadad scale. Meta-analysis was performed using Review Manager software. Finally, 13 studies were included. hCG and LHRH increased TCDR comparing with control group. The success rate of hCG and LHRH was 24 and 19%, respectively. Further, hCG and LHRH had significant effect on bilateral cryptorchidism, but not on unilateral cryptorchidism. All side effects were transitory and not severe, but if they have long-term harms were not clear. hCG and LHRH can effectively increase TCDR and there was no significant difference between them. However, the hormones cannot be recommended for everyone because of their low success rates and potential long-term harms. Further studies are needed to determine the efficacy of hormonal treatment for subtypes of cryptorchidism.

Key words

hormone - undescended testicle - systematic review

* The first 2 authors contributed equally to this work


 

  • References

  • 1 Miller DC, Saigal CS, Litwin MS. The demgraphic burden of urologic diseases in America. Urol Clin North Am 2009; 36: 11-27
    CrossrefPubMedGoogle Scholar
  • 2 Barthold JS, González R. The epidemiology of congenital cryptorchidism, testicular ascent and orchiopexy. J Urol 2003; 170: 2396-2401
    CrossrefPubMedGoogle Scholar
  • 3 Martin DC. Germinal cell tumors of the testis after orchiopexy. J Urol 1979; 121: 422-424
    PubMedGoogle Scholar
  • 4 Pottern LM, Brown LM, Hoover RN. Testicular cancerrisk among young men. J Nat Canc Institut 1985; 74: 377-381
    PubMedGoogle Scholar
  • 5 Thorsson AV, Christiansen P, Ritzén M. Efficacy and safety of hormonal treatment of cryptorchidism: current state of the art. Acta Paediatr 2007; 96: 628-630
    CrossrefPubMedGoogle Scholar
  • 6 Pyorala S, Huttunen NP, Uhari M. A review and meta-analysis of hormonal treatment of cryptorchidism. J Clin Endocr Metabol 1995; 80: 2795-2799
    PubMedGoogle Scholar
  • 7 Jadad 1 AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials 1996; 17: 1-12
    CrossrefPubMedGoogle Scholar
  • 8 Illig R, Exner GU, Kollmann F, Kellerer K, Borkenstein M, Lunglmayr L, Kuber W, Prader A. Treatment of cryptorchidism by intranasal synthetic luteinising-hormone releasing hormone. Results of a collaborative double-blind study. Lancet 1977; 2: 518-520
    PubMedGoogle Scholar
  • 9 Hagberg S, Westphal O. Treatment of undescended testes with intranasal application of synthetic LH-RH. Eur J Pediatr 1982; 139: 285-288
    CrossrefPubMedGoogle Scholar
  • 10 Karpe B, Eneroth P, Ritzén EM. LHRH treatment in unilateral cryptorchidism: effect on testicular descent and hormonal response. J Pediatr 1983; 103: 892-897
    CrossrefPubMedGoogle Scholar
  • 11 Klidjian AM, Swift PG, Johnstone JM. Luteinising hormone releasing hormone for incomplete descent of the testis. Arch Dis Child 1985; 60: 568-571
    CrossrefPubMedGoogle Scholar
  • 12 deMuinck Keizer-Schrama SM, Hazebroek FW, Matroos AW, Drop SL, Molenaar JC, Visser HK. Double-blind, placebo-controlled study of luteinising-hormone-releasing-hormone nasal spray in treatment of undescended testes. Lancet 1986; 1: 876-880
    PubMedGoogle Scholar
  • 13 Rajfer J, Handelsman DJ, Swerdloff RS, Hurwitz R, Kaplan H, Vandergast T, Ehrlich RM. Hormonal therapy of cryptorchidism. A randomized, double-blind study comparing human chorionic gonadotropin and gonadotropin-releasing hormone. N Engl J Med 1986; 314: 466-470
    CrossrefPubMedGoogle Scholar
  • 14 Wit JM, Delemarre-Van de Waal HA, Bax NM, Van den Brande JL. Effect of LHRH treatment on testicular descent and hormonal response in cryptorchidism. Clin Endocrinol (Oxf) 1986; 24: 539-548
    CrossrefPubMedGoogle Scholar
  • 15 Christiansen P, Müller J, Buhl S, Hansen OR, Hobolth N, Jacobsen BB, Jørgensen PH, Kastrup KW, Nielsen K, Nielsen LB, Pedersen-Bjergaard L, Petersen KE, Petersen SA, Thamdrup E, Thisted E, Tranebjærg L, Skakkebæk NE. Hormonal treatment of cryptorchidism – hCG or GnRH – a multicentre study. Acta Paediatr 1992; 81: 605-608
    CrossrefPubMedGoogle Scholar
  • 16 Olsen LH, Genster HG, Mosegaard A, Jørgensen FS, Hofman N, Jensen VB, Lassen LB, Rassmussen M, Vinzents L, Dammegaard L, Munck S, Bröndum-Nielsen K. Management of the non-descended testis: doubtful value of luteinizing-hormone-releasing-hormone (LHRH). A double-blind, placebo-controlled multicentre study. Int J Androl 1992; 15: 135-143
    CrossrefPubMedGoogle Scholar
  • 17 Bica DT, Hadziselimovic F. The behavior of epididymis, processus vaginalis and testicular descent in cryptorchid boys treated with buserelin. Eur J Pediatr 1993; 152: 38-42
    CrossrefPubMedGoogle Scholar
  • 18 Liu GH, Li ZC, Ge RS. Effect of LHRH with nasal spray and HCG for treatment of children’s cryptorchidism. Acta Universitatis Medicinalis Secondae Shanghai 1999; 19: 551-552
    PubMedGoogle Scholar
  • 19 Esposito C, De Lucia A, Palmieri A, Centonze A, Damiano R, Savanelli A, Valerio G, Settimi A. Comparison of five different hormonal treatment protocols for children with cryptorchidism. Scand J Urol Nephrol 2003; 37: 246-249
    CrossrefPubMedGoogle Scholar
  • 20 Zhao HT, He R, Sun J, Chen QM, Shi CR. Randomized controlled study of human chorionic gonadotrophin treatment for infantile cryptorchidism. Chin J Pediatr Surg 2010; 31: 797-799
    PubMedGoogle Scholar
  • 21 Henna MR, Del Nero RG, Sampaio CZ, Atallah AN, Schettini ST, Castro AA, Soares BG. Hormonal cryptorchidism therapy: systematic review with metanalysis of randomized clinical trials. Pediatr Surg Int 2004; 20: 357-359
    PubMedGoogle Scholar
  • 22 Fedder J, Boesen M. Effect of a combined GnRH/hCG therapy in boys with undescended testis: evaluated in relation to testicular localization within the first week after birth. Arch Androl 1998; 40: 181-186
    PubMedGoogle Scholar
  • 23 Penson D, Krishnaswami S, Jules A, McPheeters ML. Effectiveness of hormonal and surgical therapies for cryptorchidism: a systematic review. Pediatrics 2013; 131: e1897-e1907
    CrossrefPubMedGoogle Scholar
  • 24 Flanagan JN, Lehtihet M. The Response to Gonadotropin-Releasing Hormone and hCG in Men with Prior Chronic Androgen Steroid Abuse and Clinical Hypogonadism. Horm Metab Res 2015; 47: 668-673
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Dunkel L, Taskinen S, Hovatta O, Tilly JL, Wikström S. Germ cell apoptosis after treatment of cryptorchidism with human chorionic gonadotropin is associated with impaired reproductive function in the adult. J Clin Invest 1997; 100: 2341-2346
    CrossrefPubMedGoogle Scholar
  • 26 Cortes D, Thorup J, Visfeldt J. Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism. J Urol 2000; 163: 1290-1292
    CrossrefPubMedGoogle Scholar
  • 27 Ludwikowski B, González R. The controversy regarding the need for hormonal treatment in boys with unilateral cryptorchidism goes on: a review of the literature. Eur J Pediatr 2013; 172: 5-8
    CrossrefPubMedGoogle Scholar
  • 28 Komarowska MD, Hermanowicz A, Debek W. Putting the pieces together: cryptorchidism – do we know everything?. J Pediatr Endocrinol Metab 2015; 28: 1247-1256
    PubMedGoogle Scholar