Right-hand cryptorchism

[EVG]

Hello!



The dear doctor, at my son (1,5 years) a right-hand cryptorchism. Have noticed at once in a maternity home, waited for a spontaneous ptosis about one year. We were examined by the endocrinologist, a cat. Advised to carry out hormonal researches for check of function of a healthy testicle.



Have made US of organs of a scrotum:

The left testicle is in a scrotum, the sizes 157 mm, with the precise equal contours, homogeneous structure or frame. A structure of an appendage and poveska are not changed.

The right testicle above an inguinal ring, very mobile, by the sizes 106 mm, ehogennost it is moderately raised or increased. Structure or frame homogeneous.



I had following questions:



1. Hormonal research of a healthy testicle is how much necessary.

2. Whether operation of bringing down is necessary?

3. As there passes or there takes place operation, t. e. prodolzhitelnost on time, a kind of a narcosis, the rehabilitational period and t. Item?



In advance thanks.

Olga.

[ElenaK]

It is a question of a hormonal structure, its or his knowledge is necessary correctly to pick up medicinal therapy before operation, including a dose.

As a rule bringing down of a testicle is necessary in any case

[licenok]

Whether and it is impossible to take an interest, that is meant the term *quot; hormonal Oo??y*quot;? Researches Planned in this case? Influence of prospective results on decision-making?

[nao68]

Hello!



The dear doctor, at my son (1,5 years) a right-hand cryptorchism. Have noticed at once in a maternity home, waited for a spontaneous ptosis about one year. We were examined by the endocrinologist, a cat. Advised to carry out hormonal researches for check of function of a healthy testicle.



Have made US of organs of a scrotum:

The left testicle is in a scrotum, the sizes 157 mm, with the precise equal contours, homogeneous structure or frame. A structure of an appendage and poveska are not changed.

The right testicle above an inguinal ring, very mobile, by the sizes 106 mm, ehogennost it is moderately raised or increased. Structure or frame homogeneous.



I had following questions:



1. Hormonal research of a healthy testicle is how much necessary.

2. Whether operation of bringing down is necessary?

3. As there passes or there takes place operation, t. e. prodolzhitelnost on time, a kind of a narcosis, the rehabilitational period and t. Item?



In advance thanks.

Olga.



Hormonal research to do or make it is not necessary. Medicamental therapy by chorionic Gonadotropinum in the age of after 1 year as a rule is not effective. Operation is absolutely necessary for 2-nd reasons. First, a testicle being the inguinal channel if it or him to not reduce (to not lower or omit in a scrotum) till 3th years in 70 % of cases will lose ability to form spermatozoons and a man's sexual hormone Testosteron-Depotum. Secondly, the located testicle is abnormal has high chances of a malignant degeneration. Operation borrows or occupies till 2 o'clock is spent under a narcosis (the general or common anesthesia, the child sleeps during operation), the boy leaves in day of operation or next day after it or her. Pains in the field of ranki will disturb in the first week after operation. Do not delay operation!



P.S. Intimately I welcome Vas Galina Afanasevna! There Was almost in a month in Ulm, Germany. Passed or took place there hands-on training on a radical prostatectomy at a cancer of a prostate. It is impressed by German medicine. Is to that to learn!

[Andr]

[QUOTE] Hormonal research to do or make it is not necessary. Medicamental therapy by chorionic Gonadotropinum in the age of after 1 year as a rule is not effective. Operation is absolutely necessary for 2-nd reasons. First, a testicle being the inguinal channel if it or him to not reduce (to not lower or omit in a scrotum) till 3th years in 70 % of cases will lose ability to form spermatozoons and a man's sexual hormone Testosteron-Depotum. Secondly, the located testicle is abnormal has high chances of a malignant degeneration. Operation borrows or occupies till 2 o'clock is spent under a narcosis (the general or common anesthesia, the child sleeps during operation), the boy leaves in day of operation or next day after it or her. Pains in the field of ranki will disturb in the first week after operation. Do not delay operation!



QUOTE]

Nevertheless, I before operation would follow policy HG (profazi) of 8-10 injections...

[Iriska]

It is a question of a hormonal structure, its or his knowledge is necessary correctly to pick up medicinal therapy before operation, including a dose.

As a rule bringing down of a testicle is necessary in any case

For definition of dose HG it is absolutely not obligatory to investigate or research a hormonal structure. And what you wish to see, really? Dose HG - 250 500 ED in day, in/m 2 r/?Nn., 2 months, then - in 1-2 months on operative treatment.

[The administrator]

Let's tell or say so: the given opinion belongs children's andrologicheskomu to the center head ucherezhdeniju the given structure in our country. But basically dear colleagues you are free to act as you your conscience prompts.

You result or bring a classical dose. We have operating time and views on this question.

And simply to lower or omit a testicle to me it seems in general unreasonably, it is sick often they depart back.

And then, there is a mass of syndromal patients which testicle from a bay barahta will not lower or omit. Represent you take the baby with gipotalamo gipofizarnym a syndrome, etc., on a table (well were mistaken, whether poorly thick and thick...)...: (. There will be and more reasons if it or this will seem to you a little

[Strafer]

I repeat a question - what hormones and for what you wish to investigate or research, I expand or dilate it or him is that such gipotalamo-gipofizarnyj a syndrome?

You can quote opinion andrologicheskogo units not simply the largest, and the most largest center, at all be not limited to the country-though world and its or his vicinities - let's disassemble this opinion...

PS. Doctor Zhivov, it is glad to our new occurring, and, as always, concurrence of opinions.

[ana]

The children's andrology officially exists? In Morozovskoj to hospital do or make how speaks ZHivov, how much or as far as I know.

[Bandit]

What is *quot; ours ?aOaiO?*quot;? What *quot; u?o?*quot; the center? What conscience and and she here? There Is a plenty of relevant researches which confirm expediency of the standard approach stated by me. The probability of success of application of chorionic Gonadotropinum in the age of after 1 year does not exceed 20-30 %. At very big desire it is possible to spend so-called trial treatment HGCH (Pregnylum, profazi) 250 ED 2 times a week - 5 weeks. If nothing will occur or happen to a testicle (that most likely) - it is necessary to operate. That testicles not *quot; departed ?a?an*quot; - it is necessary to be able to operate, then anything and will not depart anywhere. In the West, where a testicle *quot; simply O?a?O*quot;, success of these operations of the order of 90 %.

[The Andes]

Dear Dr. Alexey Zhivov!



We too live in St.-Petersburg. How it is possible to get to you on consultation?

[_]

Dear Dr. Alexey Zhivov!



We too live in St.-Petersburg. How it is possible to get to you on consultation?



It is necessary to enter the name on reception by phone, Olga. Phones and coordinates of clinic here (http: // www.andros.ru/howtofind/index.html).

[Vasily_M]

Let's tell or say so: the given opinion belongs children's andrologicheskomu to the center head ucherezhdeniju the given structure in our country. But basically dear colleagues you are free to act as you your conscience prompts.

You result or bring a classical dose. We have operating time and views on this question.

And simply to lower or omit a testicle to me it seems in general unreasonably, it is sick often they depart back.

And then, there is a mass of syndromal patients which testicle from a bay barahta will not lower or omit. Represent you take the baby with gipotalamo gipofizarnym a syndrome, etc., on a table (well were mistaken, whether poorly thick and thick...)...: (. There will be and more reasons if it or this will seem to you a little

Know, when I for the first time have passed or have taken place specialization on endocrinology, too stood up for conservative treatment of a cryptorchism... There Were cases and absence of a testicle at 5-7- children... Now I poostereglas to tighten or delay for a long time treatment by Gonadotropinum... Even at presence subthalamic... The Another matter - nevertheless, I think, contact of the urologist to the endocrinologist should be... And before operation, or after - course HG to spend necessarily. IMHO.

[oleg 1978]

And has not received the answer in occasion of gipotalamo-gipofizarnogo a syndrome, and Tatyana already continues a line *quot; even at presence subthalamic - ---*quot; .A it that for an animal?

[barrakyda]

And has not received the answer in occasion of gipotalamo-gipofizarnogo a syndrome, and Tatyana already continues a line *quot; even at presence subthalamic - ---*quot; .A it that for an animal?

So it I have emphasized the statement of the author (drbormental) - *quot;... And then, there is a mass of syndromal patients which testicle from a bay barahta will not lower or omit. Represent you take the baby with gipotalamo gipofizarnym a syndrome, etc., on a table (well were mistaken, whether poorly thick and thick...)... *quot;.



It, so to say, irony...

[Dew]

You can sneer as much as necessary, but perhaps uvazhemye opponents will deign to agree, that at high or normal level LG, and positive chorus-th treatment by Gonadotropinum is counter-indicative to assay. This standard opinion very much many authors.

That that a cryptorchism as a rule disease systemic, instead of isolated, is known even to the hedgehog. And to state bases of endocrinology and to tell that such gipotalamo gipofizarnyj sindrom-excuse it do or make in High schools.

In occasion of operation - on mine my answer was categorical and does not go counter with yours - to operate. So, what a dust to lift?

In occasion of a children's andrology: such speciality is brought in the register in the past to year. Event is very a pity what is it has passed by to a dear audience. Just as has past passed or has past taken place apparently last kongres new technologies in pediatrics. The round table there has been devoted to a problem of a children's andrology.

Yes, one more moment why anybody from many uvazhemoj an audience was strained with the strange report uzi? What Apparatus of a class it is possible to investigate or research an appendage and appendage at 1,5 years or summer children? Here where lohotron.

[Svet]

As the High school teacher I very much-very am or be interested - as often to you came across detki one year from a sort with high LG, c it is high LG, that such a floor. Chorus-th assay at one-year-old age, criterion, indications to carrying out, also that all the same in high school teach under the terrible name *quot; gipotalamo- ???nO?*quot;, to exclude which it is necessary at the one-year-old child with a cryptorchism? And what hormones to investigate or research? LG - has already understood, still that?

[antibor]

Hello misters, that, let's discuss subjects of irony. At once I wish to note, that when I answered, gave its or his person who has no attitude or relation to medicine. But if you so insist, let's philosophize. I expect that entering in polemic with the professor of endocrinology, most likely I shall lose, nevertheless, I shall dare all taki to express the, PERSONAL OPINION, though and generated on the basis of the read through literature.

In the beginning the short answer: high level LG can be at the primary got failure testicular endokrinotsitov and at an anorchism. According to some information it is a parameter the question disputable can be raised or increased since six months, though in my opinion. But forgive or excuse and where you in my report have read through words high LG in the age of one year? horiogogoninovaja assay in 1 year? Stick please with a finger!

At once I recognize, gipotalamo gipofizarnyj a syndrome - a slang, in it or this it is not right, excuse, therefore I shall pass to more comprehensible term subthalamic a syndrome with disturbance gipotalamo - gipofizarnyh interactions and a secondary hypogonadism. I hope, that the given term is comprehensible for dostopochtimoj audiences.

Let's begin with a cryptorchism, as those. I hope that we will not have disputes that hormonal changes at a cryptorchism pljuriglanduljarnogo character. At first sight exists patogmonichnyj a parameter of a cryptorchism - LG. On the other hand at enough big group of children signs of a lesion of a thyroid gland (at 50 % of children with a cryptorchism dropping the basic exchange is marked or celebrated) are marked or celebrated. But the obesity at a cryptorchism can be caused or called and dysplastic changes in TSNS. For a cryptorchism reorganization of other hormonal systems interfaced or integrated to genesial system (adrenal, and again taki thyroid) is characteristic vtorichnoindutsiruemaja. The cryptorchism can be accompanied by isolated deficiency FSG. Whether there is a sense to stuff the child with a medicine spending assay if it is possible to take hormones of a blood?

Other word, perhaps it is necessary to consider or examine;survey the patient with a cryptorchism from endocrinologic or endocrinology positions considering two basic variants of formation of hormonal caused delays of testicles:

1 due to insufficient stimulation by Gonadotropinum (as a rule there is he, mashite "checker or block" and all will be good)

2 due to a primary androgenic failure

The second accompanies syndromes Kljanfeltera (1 % of all cryptorchisms), a testicular feminization, a congenital bilateral hypoplasia of testicles (testicles initially structurally and morfologicheski are degenerated), SHershnevskogo-, del Kastilo, Kallmena, Meddoka

It is not necessary to dump or reset from the bill got gipogonadiizm: Lorensa-Muna-the Bard-i?n?n, Pradera-Villi., a hypogonadism at a subthalamic syndrome as a result of traumatic, infectious inflammatory or tumoral lesion gipotalamo- areas. I hope to me it is not necessary to convince a dear audience, that all these statuses can be accompanied by a delay of testicles. Whether who can from you (I address to urologists) nibud approximately to distinguish syndrome pradera-o???? from a banal cryptorchism proceeding with sochetannym a lesion of a thyroid gland? Children are sometimes very similar to appearance: a Gothic palate, an obesity, a mental retardation, epikant in one case and the expanded bridge, epikant, a dysplasia and a low locating of auricles, a Gothic palate, umstvenaja backwardness in other. I have deliberately lowered or omitted the some people simtomy, I dare to assure, that any urologist does not pay attention for example to presence of a metacarpal syndrome, disturbance of an adamantine substance of tooth, a cross-section or transversal strip of a palm.

Hypogonadism at a subthalamic syndrome as a result of traumatic, infectious inflammatory or tumoral lesion gipotalamo- areas. According to the literature in an etiology lay transferred or carried fetally: an encephalitis, a toxoplasmosis, tubercular miningeoentsefalit, virus infections, birth trauma, tumours of a pituitary body, a tumour grey bugra, an oblong brain, mediobazalnogo a hypothalamus. Where it is written what to suspect these lesions at the one-year-old child wrongfully? Or what, if such child will be one on hundred that he it is not counted?

: In the image: having taken the certain set of hormones: LG, FSG, T, PRL, TTG, To, Oestradiolum (only one nyxis in a vein, and on money your assays are not more unprofitable than all), and having looked or seen their parity or ratio it is possible to understand at once whom it is necessary to stimulate, whom to operate and to that operation is not shown basically, and it is sometimes counter-indicative.

Do not find or Consider my letter as attempt of whom that uest, Simply very bitterly to explain to parents of the patient with syndrome Kljajnfeltera to which when that was reduced with testicles and have told or said, that all will be good, that will be never good anything. And in general, with reduced and then on what that to the reason the atrophied testicles is a lot of children.

It is interesting, why if me, by your retorts, surround all knowing, with perfect sense of humour, vysokvalifitsirovannye surgeons and endocrinologists?

And all taki, please, answer my question, in occasion of US? Show me appendage at the one-and-a-half-year-old child on US. I on lodzhike 400 cannot see them just as an appendage, I see only a head of an appendage. The curriculum of vision of an appendage entirely and an appendage is ready to pay.

And more a question personally to doctor Zhivovu: How much or As far as often he saw malignizirovannye testicles in the age of till 20 years?

Best regard, dr dormental

[Nazar]

Likely, I have lost ability to read texts - So, I shall try to begin all over again - here the first letters with which our conversation - *quot has begun; the Dear doctor, at my son (1,5 years) a right-hand cryptorchism. Have noticed at once in a maternity home, waited for a spontaneous ptosis about one year. We were examined by the endocrinologist, a cat. Advised to carry out hormonal researches for check of function of a healthy testicle. *quot; - whether Correctly I have understood, what to the child of one and a half year - or not?



Dr. Bormental, in the best traditions recommends this child to investigate or research, as at it or him is *quot; the, PERSONAL OPINION, though and generated on the basis of the read through literature following or next goromony-, FSG, TTG, as-

*quot; high level LG can be at the primary got failure testicular endokrinotsitov and at an anorchism. According to some information it is a parameter can be raised or increased since six months, *quot; - t.e it is necessary to investigate or research LG to exclude an anorchism at kriptorha? Or to exclude in the age of 1 year primary giopgonadizm?

Please, specify that level LG at the one-year-old child who allows you to exclude an anorchism at kriptorha. (continuation follows)

[Sasha 7777777]

There and then the doctor writes - *quot; But forgive or excuse and where you in my report have read through words high LG in the age of one year? *quot;..... *quot; stick please with a finger! _ *quot; I stick once again-what LG and what for you recommend to look to the child?

*quot; to more comprehensible term subthalamic a syndrome with disturbance gipotalamo - gipofizarnyh interactions and a secondary hypogonadism. I hope, that the given term is comprehensible for dostopochtimoj audiences. And quot;-hour from an hour is not easier, t.e we look LG in a year for diagnostics of a secondary hypogonadism - so what its or his digits allow to put us this most secondary ISOLATED hypogonadism (that is with-thit Kalmanna) . nanisms are not present.

And than will be worse Kalmannu if him to reduce a testicle?



*quot; At first sight exists patogmonichnyj a parameter of a cryptorchism - LG. And quot; - patogonomonichnym a parameter of a cryptorchism is otsustvie a testicle



*quot; On the other hand at enough big group of children signs of a lesion of a thyroid gland (at 50 % of children with a cryptorchism dropping the basic exchange is marked or celebrated) are marked or celebrated. - and for it it is necessary to beat - and it is strong..

poinzhenie the basic exchange can be from one million reasons. At first sight exists patogmonichnyj a parameter of a cryptorchism - LG. On the other hand at enough big group of children signs of a lesion of a thyroid gland (at 50 % of children with a cryptorchism dropping the basic exchange is marked or celebrated) are marked or celebrated. But the obesity at a cryptorchism can gnostiki gipotiroza not primenjatesja already godkov edak 30, from that pore. As the mankind has adjusted opredelnie TTG, which. By the way. Define or determine in roddome-and at once begin lecht giopttroz. So by one and a half years all for a long time already know, is or not gipotiroz and last kolmpensirujut, so conducting a cryptorchism under the general or common laws. (continuation follows)

[shuver]

*quot; the Second accompanies syndromes Kljanfeltera (1 % of all cryptorchisms), a testicular feminization, a congenital bilateral hypoplasia of testicles (testicles initially structurally and morfologicheski are degenerated), SHershnevskogo-, del Kastilo, Kallmena, Meddoka *quot; - so-so.... Already interestingly, especially about testicular feminizatsiju-you saw though one, simply curiously..

And with Turners too it is quite good..

[Nina of Item]

*quot; It is not necessary to dump or reset from the bill got gipogonadiizm: Lorensa-Muna-the Bard-i?n?n, Pradera-Villi., a hypogonadism at a subthalamic syndrome as a result of traumatic, infectious inflammatory or tumoral lesion gipotalamo- areas. I hope to me it is not necessary to convince a dear audience, that all these statuses can be accompanied by a delay of testicles. Whether who can from you (I address to urologists) nibud approximately to distinguish syndrome pradera-o???? from a banal cryptorchism proceeding with sochetannym a lesion of a thyroid gland? *quot; - you about what, tell or say on favour?

You wish to tell or say, that in Moscow full not treated primary gipotirozov one-year-old age, and all kriptorham should define or determine TTG or what at a syndrome though Pradera though Lawrence it is impossible to lower or omit a testicle, yet you will not define or determine LG?

at last. On Klajnfelteru - this with-thit meets at 1 of 500 novorzhdennyh, but, damn, not on LG he is diagnosed in a year in any way is not a subthalamic syndrome and what changes fact Kljajnfeltera in the offer to lower or omit a testicle?

I. Certainly. Has offered kariotipirovat all kriptorhov - but in fact it will be my, personal mnenie-and I fine understand, that reasonable people consider or count money and an opportunity. What exactly you wish to tell or say slovami-and quot; skazt to parents that all will be OO?*quot; at Klajnfeltere nediagnosirovannom? And that will be bad what the testicle will be lowered or omitted - let though three hundred Klajnfelterov?

st the reference in a year

[Alkmena]

Well.. What for so to become angry??? I at all did not wish to tell or say, that you have forgot to read texts. But I anywhere did not write that in 1 year it is necessary to define or determine LG. You to my deep regret read that wish to read through.

In occasion of diagnostics of hyperthyroidisms. Yes in maternity homes dejtvitelno should take these tests just as FKU. But if I shall give you the list of children which on what or to the reasons have not taken this analysis, or its or his results have not informed, you undertake to smear as pathosly as try to smear now me, guilty of that that the state program is not carried out?

Or perhaps you will allow to lead to you on reception of the child with a cryptorchism and a hyperthyroidism to which already 6 years and at which in our nice or famous capital of disturbance of function of a thyroid gland are revealed 1,5 back after children's androlog has sent it or him to the endocrinologist? And veins this child not in Muhosranske, and in Moscow. Now it or he is treated by the endocrinologist and does not advise while to operate. Endocrinologists in fact yours ieparhija?

Perhaps to you to send lists primarily revealed on prophylactic medical examinations at school kriptorhov?



Already interestingly, especially about testicular feminizatsiju-you saw though one, simply curiously..

Let's ask Okulov how much he saw?



You wish to tell or say, that in Moscow full not treated primary gipotirozov one-year-old age, and all kriptorham should define or determine TTG or what at a syndrome though Pradera though Lawrence it is impossible to lower or omit a testicle, yet you will not define or determine LG?

There is no I wish to tell or say that it is not necessary to catch at a scalpel not having put the diagnosis.

.

at last. On Klajnfelteru - this with-thit meets at 1 of 500 newborns, but, damn, not on LG he is diagnosed in a year in any way is not a subthalamic syndrome and what changes fact Kljajnfeltera in the offer to lower or omit a testicle?



Certainly features poperi not on LG, and more likely on high level FSG.

I wish to tell or say, that I do not see sense in a year to fruitless Klein to lower or omit an egg since risk from the anesthesiology grant or manual in that case nothing is justified. And I think that any parent if to him in a year to explain that the sense of such operation is peer pshiku, to disagree on its or her carrying out

By the way I wish to remind that I anywhere did not write that kljajnfelt - gipotolamichesky a syndrome. It is not necessary to me of another's laurels.

With impatience I wait for the further raznosa. Unfortunately access to the Internet at me only once a week, I promise to add to following time butters or oils in fire of indignation, yours faithfully



S.Bondarenko

[paka]

Dear sir Bondarenko - I do not become angry, I am afflicted to-our mum normal references are given by the urologist. What force forces you to print a heap of the erroneous conclusions?

Prdolzhaem analysis of your last message - *quot; In occasion of diagnostics of hyperthyroidisms. Yes, in maternity homes dejtvitelno should take these tests just as oeo*quot; - Damn. But we about GIPOTIROZAH, GIPOTIROZAH, GIPOTIROZAH spoke - not about tirotoksikozah, and in a maternity home screening spend on GIPOTIROZ - a devil difference. I am afraid, that with the child with tirotoksikozom. Which you are going to to me to carry, you too confuse something.

Now about a testicular feminization - at what here my friend Mr. Okulov?

Floor of the child with a testicular feminization - female at a birth .devochki win at competitions of beauty, ENTSRAMN observes not less than hundreds similar patients - well would feel ashamed snowstorm to carry. - you about them have recollected the word of honour by the way at conversation on the boy with a cryptorchism?

There was a concrete question, about concrete HEALTHY (fie, fie) the child of concrete age. And you--, Lawrence and so forth At what here all this?

The reference at a cryptorchism- is better to spend in 18 mes.. Point. At me forces will not suffice to assort all your mistakes or errors-what for to you all was necessary these badly digested data from textbooks to splash out? In occasion of a concrete question? What for?

You borrow or occupy time, showing any bits of data - be engaged in business, esteem literaturu-once again if you wish to talk about a cryptorchism in general, it is one question, on the concrete child - an another matter even if there is an Internet connection once a week, it is better to you to study, than to learn or teach. Certainly. For enja ka kdlja the teacher the parentage of your mistakes or errors - in chastosti is of interest. Data about LG - to jump or gallop in 6 months. Which you where result or bring. Concern to 6 months FETAL razvitija-but I simply physically not in forces to correct all your flaws..

[DimaDialekt]

Let's start read - by the way. And about levels goromnov.

Serum inhibin B, FSH, LH and testosterone levels before and after human chorionic gonadotropin stimulation in prepubertal boys with cryptorchidism.



Christiansen P, Andersson AM, Skakkebaek NE, Juul A.



University Department of Growth and Reproduction, GR-5064, Rigshospitalet, Denmark. peter.c@dadlnet.dk



BACKGROUND: Several studies have indicated that cryptorchidism is associated with degenerative changes in both Sertoli cells and germ cells. The gonadal peptide hormone inhibin B reflects Sertoli cell function. Low inhibin B levels are found in a large portion of formerly cryptorchid men who show compromised seminiferous tubule function. It is not known if inhibin B can be used to demonstrate early damage of seminiferous tubules in prepubertal boys with cryptorchidism. METHODS: We investigated the relationship between serum levels of inhibin B, testosterone, FSH and LH in 62 prepubertal boys with uni-and bilateral cryptorchidism. Furthermore, we investigated the changes in serum levels of inhibin B and the corresponding changes in serum levels of FSH, LH and testosterone during a short course (3 weeks) of human chorionic gonadotropin (hCG) injections in 18 of these cryptorchid boys. RESULTS: In the 62 prepubertal boys with uni-or bilateral cryptorchidism there were no significant differences in baseline levels (median and range) of inhibin B (88 (20-195) pg/ml vs 78 (35-182) pg/ml; not significant), LH (0.08 (*lt; 0.05-0.99) IU/l vs 0.06 (*lt; 0.05-1.61) IU/l; not significant) and FSH (0.60 (0.08-3.73) IU/l vs 0.85 (0.25-2.55); not significant) compared with 156 healthy prepubertal boys, and there were no differences in hormonal levels between boys with uni-or bilateral cryptorchidism. There was no correlation between baseline levels of inhibin B and FSH. In boys younger than 9 years, we found no correlation between baseline levels of inhibin B and LH whereas, in boys older than 9 years, baseline levels of inhibin B were positively correlated to baseline LH (Spearman rank correlation coefficient ((R (s)) =0.58, P=0.03). Treatment with hCG (1500 IU intramuscularly twice weekly for 3 weeks) resulted in descensus of testes in 9 out of 18 patients. In all boys but one, irrespective of age, hCG induced a marked increase in testosterone into the adult range (from undetectable to 21.8 (7.0-35.4) nmol/l; P*lt; 0.001) and completely suppressed FSH and LH levels. Serum levels of inhibin B increased significantly from 116 (50-195) pg/ml to 147 (94-248) pg/ml (P*lt; 0.05), but not uniformly. The increase in serum levels of inhibin B was inversely correlated to baseline inhibin B (Rs =-0.52, P=0.03) and baseline FSH (R (s) =-0.59, P*lt; 0.01). CONCLUSIONS: We therefore suggest that, in the prepubertal testes, inhibin B is secreted from the prepubertal Sertoli cells following hCG, whereas early pubertal testes with more differentiated Sertoli cells are not able to secrete inhibin B in response to hCG stimulation, perhaps due to lack of germ cell-derived betaB-subunits. We found (a) normal inhibin B levels in prepubertal boys with uni-or bilateral cryptorchidism, (b) that hCG stimulated testosterone markedly and suppressed FSH and LH levels and (c) that hCG treatment stimulated inhibin B levels in the youngest cryptorchid boys. In the oldest prepubertal boys no hCG-induced changes in inhibin B were shown.



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