FSH AND hCG TREATMENT IN BOYS WITH RETENTIO TESTIS

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Introduction: The medical treatment of retentio testis remains controversial because of ineffectiveness and/or side-effects. FSH seems to influence the spontaneous descent of the testis; furthermore it induces LH receptors. Therefore we performed a double-blind, placebo-controlled study to investigate the effect of FSH with hCH (half the recommended WHO dose) versus hCG alone in retentio testis patients. Methods: 22 boys with retentio testis were investigated. Retractile testis were excluded. Group A (n=14, 4 bilat, 10 unilat; mean age 3.15 yrs) was treated with 150 IU FSH 2x/wk during 2 weeks followed by 150 IU FSH and 250 IU hCG 2x/wk for another 4 weeks. Group B (n = 8, 2 bilat, 6 unilat; mean age 3.3 yrs) was treated with 250 IU hCG 2x/wk for 6 weeks. Testicular position, volume and consistency as well as the appearence of scrotum, length of penis were determined at week 0, 2, 4, 6 and 12 by 2 independent investigators. Blood investigation consisted of LH, FSH, T and SHBG. Successfull descent was considered when the testis reached a mid or low scrotal position at week 12. Results: In group A 6/18 testes descended successfully. In group B 5/10 testes descended successfully. Of the unsuccessfully treated patients 6 patients of group A and 4 of group B were operated. Of these patients 6/8 testes of group A and 4/5 testes of group B showed anatomical abnormalities, which could explain the tack of hormonal response. There were no significant diHerences in hormonal parameters between the 2 groups. In both groups no serious side effects were mentioned or observed. Conclusions: 1. Half the recommended WHO dose of hCG is sufficient to reach successful descent in 50 % of treated patients with no serious side-effects; this response rate is in agreement with the literature. 2. FSH does not seem to have an additional effect on the success rate. 3. Most of the unsuccessfully treated patients showed anatomical abnormalities at operation.