Evaluation of gonadal function in cryptorchid patients before treatment

GRINSPON, R.; BEDECARRÁS, P.; ROPELATO, M.G.; BALLERINI, M.G.; GOTTLIEB, S.; REY, R.

Mar del Plata

Congreso; XIX Reunión Anual Sociedad Latinoamericana de Endocrinología Pediátrica; 2007

Treatment of cryptorchidism is often performed without knowing the functional status of the gonads, which impairs the evaluation of treatment efficacy. Our aim was to assess the prevalence of gonadal dysfunction before treatment in cryptorchid boys and the usefulness of gonadotropin determination. In 212 prepubertal cryptorchid patients, gonadal function was classified according to AMH levels measured by ELISA, and FSH and LH were measured by IFMA (Table). Cryptorchidism Functional status % AMH pmol/L LH UI/L FSH UI/L Bilat., non palpable Normal 19 621±188 0.16±0.11 0.78±0.68 n=36 Hypogonadism 64 109±111 0.32±0.79 3.9±9.2 Agonadism 17 <3 9.8±15.2 51.3±31 Bilat., palpable Normal 24 598±326 0.08±0.05 0.89±0.46 n=42 Hypogonadism 71 188±115 0.12±0.17 1.36±1.74 Agonadism 5 <3 0.28±0.28 6.6±7.2 Unilateral Normal 85 705±281 0.14±0.14 0.87±0.62 n=134 Hypogonadism 15 262±128 0.11±0.08 0.80±0.46 Hypo/agonadism was detected in 81% of bilaterally cryptorchid boys with non palpable gonads, 76% of bilaterally cryptorchid patients with palpable gonads and 15% of unilaterally cryptorchid boys. In bilaterally cryptorchid boys, LH and/or FSH elevation predicted hypo/agonadism in 100% of the cases, but did not allow distinguishing between hypogonadism and agonadism. Lack of FSH and/or LH elevation ruled out agonadism in 98% of all cases, but did not allow distinguishing between hypogonadism and functionally normal testes. We conclude that the high prevalence of testicular dysfunction justifies hormonal assessment before treatment in cryptorchidism.