Introduction and Objectives
Efficacy of hormonal treatment in cryptorchidism is still debated. While some authors have found that human chorionic gonadotropin and luteinising-hormonereleasing hormone are very useful in causing the descent of retractile testis, randomized double blind trials have shown poor outcome of hormonal treatment in 1–5 years old boys with undescended testis. To investigate the causes of this contraversion, we aimed to compare the androgen receptor status of the appendix testis in congenital undescended and retractile testis.
Material and Methods
Total 21 appenices testis were removed from 18 boys, who underwent orchiopexy. Group U (n = 9) including 3 patients with bilateral and 3 patients with unilateral congenital undescended testis and Group R (n = 12) including 12 boys with acquired undescended testis, who were previously followed up because of retractile testis. Immunohistochemistry was carried out with BioGenex monoclonal anti-human receptor antigen (Clone: F39.4.1) and after incubation of the primary antibody, sections were stained with the fluorescein isothiocyanate conjugated goat anti-mouse secondary antibody. Sections were counterstained with 4,6-diamino-2-phenylindole (DAPI). Lightmicroscopy (immunohistochemistry) and confocal laser microscopy (immunofluorescence staining) were used to visualisation of sections.
Androgen receptor expression was found both immunohistochemistry and immunofluorescence staining in the epithelial layer of appendix testis 100% in Group R (12/12), but there was no visible androgen receptor expression in Group C (0/9).
The presence of androgen receptor in the epithelial cells of appendix testis in patients with retractile testis and absence in patients with congenital undescended testis can be a possible cause of the effectiveness of hormonal treatment in retractile testis and uneffectiveness in patients with congenital undescended testis.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.