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Penile Growth in Response to Human Chorionic Gonadotropin (hCG) Treatment in Patients with Idiopathic Hypogonadotrophic Hypogonadism
Patients
A total of 20 male patients with IHH who met the criteria for micropenis were included in this study. The results were analyzed retrospectively by chart review and were approved by an institutional review board and ethics committee. Patients with cryptorchidism or its absence according to the imaging studies conducted at the initial presentation were excluded. The hCG stimulation test was performed in all patients to exclude primary testicular insufficiency. Additionally, all men had normal basal thyroid and adrenal function. A pituitary mass lesion or a suprasellar tumor was excluded by skull X-ray and by cranial computed tomography.
Note: Idiopathic hypogonadotrophic hypogonadism (IHH) is associated with deficient pituitary gonadotropin secretion due to impaired secretion of GnRH from the hypothalamus. The deficiency may be isolated or may occur in conjunction with other disorders.1 Men with IHH present clinically with delayed sexual maturation and may have associated midline defects such as Kallman's syndrome
RESULTS
The clinical features of the patients are shown in Table 1. The patients' mean age was 18.9 years (range, 12 to 24 years). The mean testicular volume of the patients was less than 6 ml (measured by Prader orchidometer) at the time of assessment. The basal serum LH (mIU/ml), FSH (mIU/ml), and prolactin (ng/ml) levels were 0.72±0.53 (reference range, 1.3-13.0), 0.23±0.14 (reference range, 0.9-15.0), and 11.39±1.75 (reference range, 2.0-15.0), respectively (Table 1). There were no remarkable adverse events related to the hCG treatment.
Increase in serum testosterone after hCG treatment
The mean serum testosterone level was significantly increased after hCG treatment. The serum testosterone levels at baseline and after 2, 4, 12, and 24 weeks of hCG treatment were 0.90±1.35 ng/ml, 1.77±1.31 ng/ml, 3.74±2.24 ng/ml, 5.49±1.70 ng/ml, and 5.58±1.75 ng/ml, respectively (p<0.05)
Increase in penile length after hCG treatment
Penile length was measured with the penis flaccid and fully stretched. The mean penile length also increased significantly after hCG treatment. The flaccid and stretched length after hCG treatment increased from 3.39±1.03 cm to 5.14±1.39 cm and from 5.41±1.43 cm to 7.45±1.70 cm, respectively (p<0.001)
3. Increase in testicular volume after hCG treatment
The mean testicular volume measured by orchidometer increased significantly as well after hCG treatment. Testis volume increased from 5.45 cc to 6.83 cc on the left side and from 5.53 cc to 7.03 cc on the right side (p<0.005)
My question is, does anyone think this will work for otherwise "normal" individuals?
Patients
A total of 20 male patients with IHH who met the criteria for micropenis were included in this study. The results were analyzed retrospectively by chart review and were approved by an institutional review board and ethics committee. Patients with cryptorchidism or its absence according to the imaging studies conducted at the initial presentation were excluded. The hCG stimulation test was performed in all patients to exclude primary testicular insufficiency. Additionally, all men had normal basal thyroid and adrenal function. A pituitary mass lesion or a suprasellar tumor was excluded by skull X-ray and by cranial computed tomography.
Note: Idiopathic hypogonadotrophic hypogonadism (IHH) is associated with deficient pituitary gonadotropin secretion due to impaired secretion of GnRH from the hypothalamus. The deficiency may be isolated or may occur in conjunction with other disorders.1 Men with IHH present clinically with delayed sexual maturation and may have associated midline defects such as Kallman's syndrome
RESULTS
The clinical features of the patients are shown in Table 1. The patients' mean age was 18.9 years (range, 12 to 24 years). The mean testicular volume of the patients was less than 6 ml (measured by Prader orchidometer) at the time of assessment. The basal serum LH (mIU/ml), FSH (mIU/ml), and prolactin (ng/ml) levels were 0.72±0.53 (reference range, 1.3-13.0), 0.23±0.14 (reference range, 0.9-15.0), and 11.39±1.75 (reference range, 2.0-15.0), respectively (Table 1). There were no remarkable adverse events related to the hCG treatment.
Increase in serum testosterone after hCG treatment
The mean serum testosterone level was significantly increased after hCG treatment. The serum testosterone levels at baseline and after 2, 4, 12, and 24 weeks of hCG treatment were 0.90±1.35 ng/ml, 1.77±1.31 ng/ml, 3.74±2.24 ng/ml, 5.49±1.70 ng/ml, and 5.58±1.75 ng/ml, respectively (p<0.05)
Increase in penile length after hCG treatment
Penile length was measured with the penis flaccid and fully stretched. The mean penile length also increased significantly after hCG treatment. The flaccid and stretched length after hCG treatment increased from 3.39±1.03 cm to 5.14±1.39 cm and from 5.41±1.43 cm to 7.45±1.70 cm, respectively (p<0.001)
3. Increase in testicular volume after hCG treatment
The mean testicular volume measured by orchidometer increased significantly as well after hCG treatment. Testis volume increased from 5.45 cc to 6.83 cc on the left side and from 5.53 cc to 7.03 cc on the right side (p<0.005)
My question is, does anyone think this will work for otherwise "normal" individuals?
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