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Old 05-11-2012
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Question Testosterone levels in cryptorchidism

The FA 2012 errata states that cryptorchidism presents with increased LH and testosterone. I know that testosterone production isn't affected by increases in temperature, so shouldn't testosterone and LH levels be normal, since Leydig cell function is intact?

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Old 05-12-2012
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You are right. It's generally believed that the increased tempertaure in undescended testis affects spermatogeneis rather than hormonal levels, however I found this article http://www.ncbi.nlm.nih.gov/pubmed/11423739 which states that there might be increased LH and FSH levels in such patients.

However, I think what's important in real life and therefore in the USMLE exam, is to remember that patients with bilateral cryptorchidism might actually have "absent testes", in such a case it's wise to measure the hormonal level to avoid unnecessary surgical exploration. They usually do "hCG stimulation test" in which you give them IM hCG and then measure Testosterone response. Boys with anorchidism do not respond, whereas boys with bilateral cryptorchidism respond with increased testosterone production.

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Old 05-12-2012
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Quote:
Originally Posted by Sabio View Post
You are right. It's generally believed that the increased tempertaure in undescended testis affects spermatogeneis rather than hormonal levels, however I found this article http://www.ncbi.nlm.nih.gov/pubmed/11423739 which states that there might be increased LH and FSH levels in such patients.

However, I think what's important in real life and therefore in the USMLE exam, is to remember that patients with bilateral cryptorchidism might actually have "absent testes", in such a case it's wise to measure the hormonal level to avoid unnecessary surgical exploration. They usually do "hCG stimulation test" in which you give them IM hCG and then measure Testosterone response. Boys with anorchidism do not respond, whereas boys with bilateral cryptorchidism respond with increased testosterone production.

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Aweome...
I love this forum man...:-)
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