Hormone Therapy for Undescended Testicle
|human chorionic gonadotropin (hCG)|
How It Works
Human chorionic gonadotropin (hCG) stimulates the testicles to release testosterone . As a result, a boy’s undescended testicle may complete its descent, at least temporarily.
HCG usually is injected into a muscle, such as in the buttocks, and may be given daily or weekly.
Why It Is Used
A doctor may suggest hCG shots to help decide whether surgery is needed. If the testicle can be made to descend using hormone therapy, surgery may not be needed. If the testicle does not descend—even temporarily—with hCG shots, it is not likely to do so on its own. Surgery may be needed.
HCG also stimulates enlargement of the testicles and growth of blood vessels to the testicles. Surgery may be easier when the testicle is larger and has an improved blood supply.
Some testicles may descend only part of the way or for a short time, when a boy is treated with hormones. But this may still be helpful, because the testicle may descend to a position that is easier to treat with surgery.
How Well It Works
Hormone therapy alone stimulates the testicles to complete their descent into thescrotum in about 20 out of 100 males who are treated. 1 But the testicles may move back out of the scrotum (reascend). This happens more often when the testicle was originally in a high position, such as in the inguinal canal or abdomen.
All medicines have side effects. But many people don’t feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine your child takes. Side effects are also listed in the information that comes with the medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after your child takes the medicine for a while.
- If side effects still bother your child and you wonder if he should keep taking the medicine, call your doctor. He or she may be able to lower the dose or change the medicine. Do not suddenly have your child quit taking the medicine unless your doctor says so.
Call 911 or other emergency services right away if your child has:
- Trouble breathing.
- Swelling of the face, lips, tongue, or throat.
Call your doctor if your child has:
Side effects of this medicine include:
- Growth of the penis and testes.
- Growth of pubic hair.
- Rapid increase in height.
These side effects are normal responses to increased levels of testosterone in males. Most usually fade away after treatment ends. In many cases, treatment with hCG does not last long enough for these side effects to appear.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
This medicine has caused the sexual organs of some boys to develop too quickly.
In some boys, an undescended testicle will descend during puberty without needing hCG. Talk to your doctor about the pros and cons of hCG treatment early on or waiting until your child has gone through puberty.
Medicine is one of the many tools your doctor has to treat a health problem. If your child takes medicine as your doctor suggests, it will improve your child’s health and may prevent future problems. If your child doesn’t take the medicines properly, his health (and perhaps life) may be at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes.
- Barthold JS (2012). Abnormalities of the testis and scrotum and their surgical management. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 4, pp. 3557–3596. Philadelphia: Saunders.
Last Revised: January 31, 2013
Author: Healthwise Staff
Medical Review: John Pope, MD – Pediatrics & Peter Anderson, MD, FRCS(C) – Pediatric Urology