Pituitary and gonadal function in prepubertal and pubertal boys with hypospadias

Abstract

Abstract. Luteinizing hormone releasing hormone (LRH) and human chorionic gonadotrophin (hCG) tests were performed in 18 prepubertal and 29 pubertal boys with hypospadias to examine pituitary and gonadal function. Thirty-one normal boys were also examined as controls. In the prepubertal group, the mean level of serum peak LH after LRH was significantly higher and the mean level of serum peak testosterone after hCG was significantly lower in boys with hypospadias than in normal boys, though about half of the patients had peak LH levels within ± 2 sd of the normal mean. There was little or no response to hCG in 3 out of 18 boys with hypospadias. In the pubertal group, serum levels of LH, FSH and testosterone in all cases were clearly higher than those in the prepubertal group and distinct or moderate responses to LRH and hCG were found in all boys including patients examined. Although serum basal FSH and testosterone levels were similar in the two groups, the mean levels of serum basal LH, peak LH and FSH in LRH test were significantly higher and the mean level of serum peak testosterone after hCG was significantly lower in boys with hypospadias than in normal boys. However, more than half of the patients had these levels within ± 2 sd of the normal means. The difference was more marked in LH than in FSH levels. An elevated mean serum FSH suggests hypofunction of not only the Leydig cells but also of the seminiferous tubules at least in some boys with hypospadias.