Management of a boy with hypogonadism.

REY, R.; BERGADÁ, I.; ROPELATO, M.G.; GOTTLIEB, S.

Progress in Paediatric Urology

Año: 2006; p. 27 - 46

Two distinct compartments form the male gonad: the seminiferous tubules, containing Sertoli and germ cells, and the interstitial tissue, where lie the androgen-secreting Leydig cells. Germ cells give rise to the spermatozoa in the adult, whereas Sertoli cells give functional support to germ cells and also have an active secreting capacity. The normal function of the testis depends on pituitary gonadotrophins but also on an intricate interaction among the different testicular cell populations. Male hypogonadism may be defined as the defective function of the testicular compartments. Since the functional importance of each testicular cell population varies along foetal and postnatal life, the clinical manifestations of male hypogonadism may differ according to age. In this review, we will focus on the aetiology, pathophysiology, clinical manifestations and management of male hypogonadism during infancy, childhood and early stages of puberty. We will only discuss hypogonadal disorders in patients with male genitalia; foetal hypogonadism resulting in intersex disorders will not be dealt with in this chapter.