Genetic, hormonal, and anatomical factors are believed to be involved in the etiology of
undescended testes. Due to increased risk of
infertility,
testicular cancer, torsion and/or accompanying
inguinal hernia (>90%) as well as cosmetic concerns, all these patients require treatment. In this review paper, we aimed to evaluate the success rates of treatment modalities used in
undescended testes, beginning from 1930 to the present, and to draw attention to the possible risks and benefits and also the efficacy of hormonal
therapy in the management of the disorder, which is still a controversial issue. Hormonal
therapy may lead to penile growth, painful erection, and behavioral changes while on treatment. In recent years, it has been reported that
human chorionic gonadotropin (hCG) treatment was associated with interstitial
edema due to increased vascular permeability,
inflammation-like changes, and several adverse effects on germ cells by increasing pressure and apoptotic process. It has also been reported that
LHRH analogues have positive effects on germ cells by increasing fertility in patients undergoing unilateral or bilateral
orchiopexy. In some studies, the success rate of hCG treatment was reported to be higher following
buserelin. In some other studies, hCG treatment was recommended before
orchiopexy to reduce the risk for surgical
ischemia. There are a limited number of randomized controlled studies, so evidence showing the efficacy of hormonal
therapy is insufficient. According to the 2007 Consensus Report of Nordic countries, it is recommended that surgery is the first-line treatment modality in
undescended testes and that it should be performed by pediatric surgeons and urologists at the age of 6-12 months.