Buradasınız

Anasayfa » Content

İnmemiş testisli çocuklarda hormonal tedavi: prospektif klinik bir çalişma

Journal Name:

  • Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2010

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: It is aimed to investigate the effects of human chorionic gonadotrpin (hCG) treatment on testicular descent and volume, penile length, serum antisperm antibodies (ASA), follicle-stimulating hormone (pSH), luteinizing hormone (LH) and total testosterone levels in children with undescended testis (UDT). Materials and Methods: 46 prepubertal children with UDT were included in the study. Patients were divided into two groups as Placebo (n=17) and Pregnyl (n=29). 6 of 29 patients (20,6%) in Pregnyl group were excluded from the study as testicular descend was achieved with the hormonal treatment. Pregnyl group (n=23) received 100 IU/kg i.m. dose of hCG once a week for 3 weeks. Placebo group received i.m. Sp injections once a week for 3 weeks. Orchiopexy was performed each patients in 1 week after the medical treatment. Testicular locations and volumes were determined with USG; penile lengths, serum levels of ASA, total testosteron, pSH and LH were measured before the treatment and one month after the surgery. Results: The penile length, testicular volume and serum total testosterone level were increased significantly in Pregnyl group following surgery (p<0,001). However, no significant differences were detected in serum ASA, pSH and LH levels before and after the treatment in both groups. Conclusion: Hormonal treatment with hCG may provide testicular descent and may be considered as a treatment modality prior to surgery in children with UDT.Serum ASAblevels ,which may have an influence on the infertility, does not changes with the hormonal treatment before and after the surgery. This finding, beside the testicular descent, also supports the hormonal treatment option prior to surgery in children with UDT
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: inmemiş testisli çocuklarda human koryonik gonadotropin (hCG) tedavisinin testis inişine ve hacmine, penis boyuna, serum antisperm antikor (ASA), folikül stimulan hormon (pSH), luteinizan hormon (LH) ve total testosteron düzeylerine olan etkilerini araştırmak. Gereç ve Yöntem: Çalışmaya inmemiş testis tanısı almış 46 prepubertal olgu dahil edildi. Hastalar Plasebo (n=17) ve Pregnyl (n=29) olmak üzere iki gruba ayrıldı. Pregnyl grubundaki 6 olguda (%20,6) hCG tedavisi sonrasında testis inişi oldu ve bu olgular çalışmadan çıkartıldı. Plasebo grubuna 3 hafta boyunca haftada bir kez i.m. Sp, Pregnyl grubuna ise 3 hafta boyunca haftada bir kez 100 IU/kg i.m. hCG uygulandı. Hastalara tıbbi tedavi tamamlandıktan sonra 1 hafta içerisinde orşidopeksi yapıldı. Olguların tıbbi tedaviden hemen önce ve orşidopeksiden 1 ay sonra ultrasonografi ile testis boyutları ve yerleşimleri değerlendirildi ve penis boyları, serum ASA, pSH, LH ve total testosteron düzeyleri ölçüldü. Bulgular: Penis boyu, testis hacmi ve serum total testosteron düzeyleri Pregnyl grubunda, Plasebo grubuna göre anlamlı düzeyde artış gösterdi (p<0,01). Serum ASA, pSH ve LH değerleri karşılaştırıldığında, her iki grup arasında istatistiksel olarak anlamlı farklılık saptanmadı. Sonuçlar: İnmemiş testisli çocuklarda hormonal tedavi testis inişini sağlayabilir ve cerrahi tedavi öncesinde bir tedavi seçeneği olarak düşünülebilir. İnfertilitede rolü olabilen serum ASA düzeyleri hormonal tedaviden etkilenmemiştir. Testis inişini sağlamanın yanında bu bulgu da, inmemiş testiste hormon tedavisinin kullanımını desteklemektedir.
FULL TEXT (PDF): 
PDF icon arastirmax-inmemis-testisli-cocuklarda-hormonal-tedavi-prospektif-klinik-bir-calisma.pdf
  • 1
14-18
  • Turkish

REFERENCES

References: 

1. Umakanth A, Khatwa and P.S.N. Menon. Management ofUndescended Testis. İndian J Pediatr 2000; 67 (6): 449.
2. Rajfer J. Surgical and hormonal therapy for cryptorchidism: An Overview. Horm Res 1998; 30: 139.
3. Berkowitz GS, Lapinski RH, Dolgin SE, Gazella JG,
S.D.Ü. Tıp pak.
Derg
. 2010:17(1)/14-18
18
Gürsoy, inmemiş testis ve hormonal tedavi.
Bodian CA,
Holzma
n IR. Prevalance and natural history ofcryptorchidism. Pediatrics 1993; 92: 44.
4. Hjertkvist M, Dauber JE, Bergh A. Cryptorchidism: A registry-based study in Sweden on some factors of some possible etiological importance. J Epidemiol CommunityHealth 1989; 146: 324.
5. Y. Kubota, S. Nef, P. Farmer, C. Temelcos, L. Parada, J. Hutson. Leydig insulin-like hormone, gubernacular development and testicular descent. J Urol 2001; 165:
1673.
6. Gill B. Kogan S. Crytorchidism: Current consept. PediatrClinNorthAm 1997; 44: 1211.
7. Elder JS. The Undescended Testis: Hormonal and surgical management. Surg Clin North Am 1988; 68:
983.
8. Miller OF, Stock JA, Cilento BG, McAleer IM, Kaplan GW. Prospective evaluation ofhuman chorionic gonadotropin in the differentiation ofundescended testes from retractile testes. J Urol 2003; 169: 2328.
9. Bukowski TP, Sedberry S and Richardson B. Is human chorionic gonadotropin useful for identifying and treating nonpalpable testis? J Urol 2001; 165: 221.
10. MacKinnon AE. The undescended testis. Indian J Pediatr2005; 72: 429.
11. Kapur DK, Ahuja GK. Immunocytochemistry ofmale reproductive organs. Arch Androl 1989; 23(3): 169.
12. Leung WY, Poon M, Fan TW, Siu KW, Chung KW, Kwok WK, Kwok CH. Testicular volume ofboys after inguinal herniotomy: combined clinical and radiological follow-up. Pediatr Surg Int 1999; 15(1): 40-1.
13. Canavese F, Cortese MG, Magro P, Lonati L, Teruzzi E, de Sanctis C, et al. Cryptorchidism: medical and surgical treatment in the 1st year oflife. Pediatr Surg Int 1998; 14: 2.
14. Lala R, Matarazzo P, Chiabotto P, Gennari F, Cortese MG, Canavese F, et al. Early hormonal and surgical treatmentofcryptorchidism. JUrol 1997; 157: 1898.
15. Grasso M, Buonaguidi A, Lania C, Bergamaschi F, Castelli M, Rigatti P. Postpubertal cryptorchidism: Review and evaluation ofthe fertility. EurUrol 1991; 20: 126.
16. Mininberg DT, Rodger JC, Bedford JM. Ultrastructural evidence ofthe onset oftesticular pathological conditions in the cryptorchid human testis ithin the firstyearoflife.JUrol 1982; 128: 782.
17. Hadziselimoviç, F: Hormonal treatment In: Hadziselimoviç MD (Ed): Cryptorchidism: ManagementandImplications. Berlin: SpringerVerlag 1983; 101-14.
18. Rajfer J, Handelsman DJ, SwerdloffRS, Hurwitz R, Kaplan H, Vandergast T. Hormonal therapy of cryptorchidism: arandomized, double-blind study comparing human chorionic gonadotropin and gonadotropin-releasing hormone N Engl J Med 1986; 314: 466.19
19.
Üna
l D, Yeni E, Verit A, Çiftçi H. İnmemiş testiste
primer human
koriyoni
k gonadotropin tedavisine yanıtı etkileyen faktörler. Türk Üroloji Dergisi 2002; 28(2):
166
20. Fedder J, Boesen M: Effect ofacombined GnRH/hCG therapy in boys with ndescended testicles: Evaluated in relation to testicular localization within the first week after birth. Arch Androl 1998; 40: 181.
21. Garagorri JM, Job JC, Canlorbe P. Results in early treatment ofcryptorchidism with human chorionic gonadotropin.JPediatr. 1982; 101: 923.
22. Job JC, Canlorbe P, Garagorri JM, Toublanc JE. Hormonal therapy of cryptorchidism with human chorionic gonadotropin (hCG) Urol Clin N Amer 1982; 9: 405.
23. Cortes D, Thorup J, Visfeldt J, Hormonal treatment may harm the germ cells in1to3- year-old boys with cryptorchdism.JUrol2000; 162: 1290.
24. Heıskanen P, Bıllıg H, Topparı J, Kaleva M, Arsalo A, Rapola J, et al. Appoptotic cell death in the normal and cryptorchid human testis: the effect ofhuman chorionic gonadotropin on testicular cell survival. PediatrRes 1996; 40: 351.
25. Christiansen P, Müller J, Buhl S, Hansen OR, Hobolth N, Jacobsen BB, et al. Hormonal treatment of cryptorchidism-hCG or GnRH- a multicentre study. ActaPediatr 1992; 81: 605.
26. Giannopoulos MF, Vlachakis IG, Charissis GC. 13 years' experience with the combined hormonal therapy ofcryptorchidism. Horm Res 2001; 55: 33.
27. Walsh PC, Curry N, Mills RC, Siiteri PK. Plasma androjen response to hCH stimulation in prepubertal boys with hypospadias and cryptorchidism. J Clin Endocrinol Metab 1976; 42: 52.
28. Cacciari E, Gicognani A, Prazzoli P, Zappola F, Tassoni P, Bernardi F, et al. Hypophysogonadal function in the cryptorchid child: differences between unilateral and bilateral cryptorchids. Acta Endocrinol 1976; 83: 182.
29. Gendrel D, Roger M, Job JC. Plasma gonadotropin and testosterone values in infants with cryptorchidism. JPediatr 1980; 97: 217.
30. Muinck K, Hazebroek FWJ, Drop SLS, Degenhart HJ, Molenaar JC, Visser HKA.
Hormonal evaluation of boys with undescended testes during their first year oflife. J Clin Endocrinol Metab 1988; 66: 159.
31. Urry RL, Carrell DT, Star NT, Snow BW and Middleton RG. The incidence ofantisperm antibodies in infertility patients with a history ofcryptorchidism. J Urol 1994; 151: 381.
32. Lenzi A, Gandini L, Lombardo F, Cappa M, Nardini P, Ferro F, Borrelli P, and Dondero F. Antisperm antibodies in young boys. Andrologia 1991; 23: 233.
33. Sinisi AA, Pasquali D, Papparella A, Valente A, Orio F, Esposito D, et al. Antisperm antibodies in cryptorchidism before and after surgery. 1998;
160:1834.

Thank you for copying data from http://www.arastirmax.com