The Use of Gonadotropic Hormones in the Treatment of Undescended Testes: Preliminary Report

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Abstract
Smith and Engle have shown that the injection of extracts of the anterior lobe of the pituitary into immature animals produces an increased growth of all the tissues of the testes, and, as a result of stimulation of the interstitial tissue, enlargement of the penis and accessory genital glands. Spermatogenesis is not produced in immature mammals by means of these extracts. Similar results are obtained with extracts of pregnancy urine, the gonadotropic principle (A.P.L. or anterior-pituitary-like hormone) of which is probably derived from the placenta. Engle has also shown that the injection of extracts of anterior lobe or of pregnancy urine causes descent of the testes in immature monkeys, in which animals they are situated in the inguinal canal. Eleven patients with undescended testes, aged 4½ to 15 years, have been treated with the gonadotropic hormones extracted from pregnancy urine. The dose used in most cases was 500 rat units injected intramuscularly twice weekly. Five of the patients had bilaterally undescended testes: during treatment both testes descended into the scrotum in two cases, one descended in each of two cases, and in the remaining case the position of the testes is unchanged. The remaining six had unilaterally undescended testes; of these, three have descended into the scrotum. Thus, nine of sixteen undescended testes have entered the scrotum during treatment. The time taken to effect this change varied from two to eleven weeks. The testes which have not yet responded have received treatment for from three to nine weeks. The mechanism whereby the descent is brought about is unknown. In view of the rather unsatisfactory surgical results, it is felt that in the treatment of undescended testes a trial should be made of this form of therapy before surgical measures are considered.