Post-operative Use of Human Chorionic Gonadotrophin (u-hCG) in Patients Treated for Intrabdominal Undescended testes

Introduction: Testicular volume and function improvement of intrabdominal testes after orchiopexy is still under discussion. The aim of this study is to report our experience with post-operative use of human chorionic gonadotrophin to achieve higher testicular volume and function, respect to untreated patients

Methods: A prospective study was done using subjects who underwent orchidopexy between September 2010 and September 2016 for unilateral intrabdominal undescended testes. All patients were treated by the same surgeon with laparoscopic one-stage Fowler-Stephens technique. After surgery (2 weeks) those patient parents who accepted to use hormonal therapy, had to follow a 6 weeks sheme. Patients received subcutaneous 500UI (Gonasi-HP) weekly. A follow-up was performed at the end of therapy and 6 months later. Testicular volume was measured at each visit by ultrasound and compared with the untreated one.

Results: Forty-five patients were enrolled and treated with a mean age of 18.0±9.7months. 32 patients received post-oprative hormonal therapy. There were no cases of adverse effects nor droupout. All patients completed follow-up. There were no cases of testicular atrophy in both groups. At 6 months among treated patients 26 (81%) subjects achieved normal testicular size while the other had still smaller volume. Among untreated patients, 6 (46%) subject achieved normal testicular size. (p<0.05)

Conclusions: Despite the role of hormonal therapy is still under discussion, especially for post-operative treatment, our results suggest that it is safe and useful to improve testicular volume; treated testes have also a good stifness respect to untreated testes