Andrology: Effectiveness of long-acting gonadotrophin-releasing hormone agonist treatment in combination with conventional therapy on testicular outcome in human orchitis/epididymo-orchitis

A group of 24 patients suffering from acute post-pubertal orchitis/epididymo-orchitiswere prospectively randomized to treatment over a total periodof 3 months with a combined conventional plus long-acting gonadotrophin-releasinghormone analogue (GnRHa) (leuprolide, 3.75 mg every 27 days)therapy (n = 13, group A) or conventional therapy alone (n =11, group B) respectively, in order to verify any differencesin clinical and sperm outcome during treatment and follow-up.Seven patients affected by uncomplicated mumps (group C), receivingGnRHa for 3 months, served as an additional control group. Combinedleuprolide plus conventional therapy provided better outcomesthan conventional therapy alone in terms of scrotal ultrasoundscans and serum antisperm antibodies (ASA) at time of presentationand monthly thereafter throughout the study: the most soliddata relate to testicular atrophy in three out of 11 patientsfrom group B and their sAb positivity persisting, as opposedto zero out of 13 in group A. Moreover, semen analyses performedat 3–6 months after therapy withdrawal revealed in groupsA and C mean total sperm counts and percentages of oval formssignificantly higher than those observed in group B. It is concludedthat GnRHa treatment is a promising pharmacological tool withno side-effects, effective in reducing testicular vascular leakagesin male orchitis.