12 A DOUBLE BLIND PLACEBO CONTROLLED (dbpc) STUDY OF LHRH TREATMENT OP UNI-& BILATERAL CRYPTORCHIDISM

摘要

250 prepubertal boys were treated with LHRH nasal spray (HOE 471) 400 ug t.i.d.; 28 days in dbpc study. Whenever a 2nd Rx course proved unsuccessful after a 4wk interval, orchidopexy was performed.Complete descent: group (gr) a (age 1-2 yrs, 37 boys) 4/41 testes (10%); gr b (age 2-6 yrs, 85 boys) 16/97 testes (16%) gr c (age 6-12 yrs, 91 boys) 48/118 testes (40%). 8 testes descended during placebo Rx. 30 testes needed 2 Rx courses. Relapse in 9 testes. An additional Rx course successful in 5 testes.Surgical findings in 139 boys: Passed through the inguinal canal but obstructed with processus vaginalis closed or narrow canal: gr a: 40%; gr b, c: 65%. Wide open processus vaginalis with 50% major epididymal deformities: gr a: 40%; gr b, c: 27%. No testes: gr a: 16%; gr b, c: 8%.Hormonal data: Before Rx: Testosterone(T) response to 1500 U HCG i.m. (gr a>gr b>gr c; p p < 0,05). No change in basal T values &bmacr; and ā Rx in gr a-c. No hormonal differences were found between uni- and bilateral cryptorchidism nor in success and failure groups.We conclude that the major anatomical abnormalities and lowest success rate to hormonal Rx were found in gr a (1-2 yrs). Our hormonal data do not support the theory that the mode of action of LHRH Rx is thru activation of the pituitary gonadal axis.