9 CRYPTORCHIDISM: COMPARISON OF 2 PROTOCOLS OF TREATMENT BY HUMAN CHORIONIC CONADOTROPIN (hCG)

It is Deneved that the positive action of hCG on cryptorchidism is mediated by the rise in endogenous testosterone (T). Previous studies have shown that plasma T rises steadily for 4-5 days (d.) after a single hCG injection (inj.). This study was undertaken to test the hypothesis that it is unnecessary to repeat inj. belore that peak. The proposed protocol (Rx) (I) consisted of 4 IM inj. of 100 IU/kg of hCG at 4 (n = 16) or 5 d. intervals (n = 79). Results, being similar, are given in the total group (I) (n = 95) and compared to that of a previous Rx (II) using 7 inj. of 1500 IU of hCG every 48 h (group II, n = 440). The % of unilateral (UC; 60%) and bilateral cryptorchidism (BC; 40%) was identical in both groups. Success (complete descent) was recorded in 50.9% of UC and 50% of BC in group I, and 40.7% of UC and 36.7% of BC in group II. Rate of relapse (at 1-4 yrs) was similar in group I (9%) and II (10%). Plasma T was measured respectively 4 and 1 d. after the last inj. in Rx I and II. Mean (±SD) T levels (ng/dl) were not different whether Rx was successful or not, either with Rx I (392 ± 207 and 430 ± 207) or II (495 ± 247 and 541 ± 304). In total groups, T levels were lower (p = 0.003) with Rx I (410 ± 207) than with Rx II (516 ± 273), possibly due to a relatively late time of sampling in Rx I. Finally, T values were normally distributed in Rx I but not in Rx II (median being respectively 384 and 443).