评价人绒毛膜促性腺激素治疗在儿童睾丸缩回治疗中的作用

S. Berdawd, Abdulrahman Taha, H. Hadi
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摘要

背景与目的:缩支性睾丸在儿科人群中较为常见。本研究对睾丸收缩的男孩进行随访,探讨其自然病程以及激素治疗和手术治疗的必要性。方法:诊断为缩回性睾丸的男孩110例,年龄1.5 ~ 10.1岁,平均3.2岁,单侧67例(60.9%),双侧43例(39.09%)。平均随访时间为4.9±1.3年。病史和检查证实诊断,超声测量睾丸大小。结果:47例(42.72%)患者接受了人绒毛膜促性腺激素治疗(双侧17例,单侧30例)。32例(68.1%)男童有反应,12例双侧,20例单侧。15名男孩(31.9%)出现反应失败。110名男孩中有14名(12.72%)接受了睾丸切除术,其中12名双侧病例中有1名(8.3%),20名单侧病例中有2名(10%)对人绒毛膜促性腺激素注射有反应,5名双侧病例中有2名(40%),10名单侧病例中有1名(10%)对治疗无效。在未接受治疗的患者中,26例双侧患者中有6例(23.1)行了睾丸切除术,37例单侧患者中有2例(5.4%)行了睾丸切除术。结论:虽然睾丸下降是通过短期激素治疗实现的,但研究显示,接受人绒毛膜促性腺激素治疗和未接受人绒毛膜促性腺激素治疗的睾丸切除术需求无显著统计学差异。
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Evaluation of the role of human chorionic gonadotropin therapy in the management of retractile testes in children
Background and objective: Retractile testis is relatively common in pediatric population. This study followed up boys with retractile testis to investigate the natural course and the need for hormonal therapy and surgical treatments. Methods: A total of 110 boys aged 1.5-10.1 years (mean: 3.2 years) diagnosed as retractile testes, 67 (60.9%) unilateral and 43 (39.09%) bilateral. The mean follow-up period was 4.9±1.3 years. The diagnosis is confirmed on history and examination and ultrasound was made for measuring the size of the testis. Results: A total of 47 (42.72%) cases received human chorionic gonadotropin (17 bilateral and 30 unilateral). Response occurred in 32 boys (68.1%),12 bilateral and 20 unilateral. Failure of response occurred in 15 boys (31.9%). Fourteen of 110 boys (12.72 %) were referred for orchiopexy, including 1 of 12 (8.3%) of bilateral cases and 2 of 20 (10%) of unilateral cases who responded to human chorionic gonadotropin injection, 2 of 5 bilateral cases (40%) and 1 in 10 unilateral cases (10%) in those did not respond to treatment. In those who did not receive treatment, orchiopexy was performed in 6 of 26 bilateral cases (23.1) and in 2 of 37 unilateral cases (5.4%). Conclusion: Although testicular descent was achieved by short-term hormone therapy, the study revealed that there is no significant statistical difference for the need for orchiopexy between those received and those did not receive human chorionic gonadotropin.
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