Early medical and surgical treatment of cryptorchidism: clinical,anatomic, and histologic findings

In 56 boys more than 6 month of age with cryptorchidism, luteinizing hormone releasing hormone (LHRH) was administered as a nasal spray 1.2 mg/day for 4 weeks. The nonresponders received human chorionic gonadotropin (HCG) 500 IU i.m. three times a week for 3 weeks. With the combined treatment, 46.5% of testes descended into the scrotum. Testicular descent occured more often in patients whose testes were located in a lower position. The initial position of the testes at clinical examination correlated significantly with the position at surgical inspection and the extent of epididymal malformation: the higher the clinical position of the testes, the more pronounced the maldescent and epididymal malformation. Histological findings indicated a paucity of germinal epithelium and atrophy of the Leydig cells. A significant inverse correlation existed between age at surgery and number of spermatogonia. Therefore, we advocate the earliest feasible treatment for cryptorchidism with a combination of LHRH and HCG, and for non-responders a surgical corrective procedure.