Plasma Androgen Response to hCG Stimulation in Prepubertal Boys with Cryptorchidism and Hypospadias

Park, Young Min; Park, Yong Hyun

Abstract

Cryptorchidism and hypospadias are the most common disorders of sexual differentiation in the male. Although the etiology of these disorders is obscure, they represent abnormalities in androgen dependent events that occur relatively late in male sexual differentiation. The response of plasma testosterone to hCG stimulation in cryporchidism and hypospadias has been studied by several investigators with different protocols and discrepant results. In this study, hCG test was carried out in prepubertal bodes with unilateral and bilateral cryptorchidism and hypospadias to study the function of the Leydig cells of the testis. Ten normal boys (aged 2 to 9 years, averaged 5.9 years), sixteen boys with unilateral cryptorchidism (aged 1 to 9 years, averaged 4.4 years), ten boys with bilateral cryptorchidism (aged 1 to 9 years. averaged 4.2 years) and nine boys with hypospadias (aged 2 to 9 years, averaged 5.7 years) were investigated. Blood samples were taken before and 72 hours after 5,000 IU hCG administration to measure serum delta 4 androstenedione (delta 4) , testosterone and dihydrotestosterone (DHT) levels by radioimmunoassay. The results were as follows : l. The mean basal serum At testosterone and DHT levels of the unilateral and bilateral cryptorchidism and hypospadias groups were not significantly lower than those in the normal control. 2. Significant increases in serum delta 4, testosterone and DHT levels by hCG stimulation were found in normal control, unilateral and bilateral cryptorchidism and hypospadias groups. 3. The mean absolute increments of serum #t testosterone and DHT after hCG stimulation in boys with hypospadias were significantly. lower than those in the normal control and unilateral cryptorchidism. Also the mean absolute increments of serum testosterone after hCG stimulation in boys with bilateral cryptorchidism were significantly lower than those in normal control and unilateral cryptorchidism. These data suggest that the testicular Leydig cell ability. in boys with hypospadias and bilateral cryptorchidism was decreased than those or normal control.