Testicular damage, secondaryE23.0
Synonym(s)
Hypogonadism hypogonadotropic; Hypogonadotropic hypogonadism; secondary testicular dysfunction; Testicular dysfunction secondary
DefinitionThis section has been translated automatically.
Secondary damage to the germinal epithelium and/or Leydig's intermediate cells in the testis due to reduced secretion of the gonadotropins FSH and/or LH. As in primary testicular damage, usually reduced testicular size (less than 10 ml volume of one testis) and leading to infertility.
Occurrence/EpidemiologyThis section has been translated automatically.
Rather rare cause of infertility in men (1-3%).
EtiopathogenesisThis section has been translated automatically.
The most frequent damage to the adenohypophysis and/or the hypothalamus ( Kallmann syndrome).
TherapyThis section has been translated automatically.
- Fertility can be achieved in individual cases by gonadotropin substitution (over 1-2 years) In men who wish to have children, substitution can be started with 1000-2000 IU HCG (e.g. Choragon 1500) 3 times a week until normal testosterone levels are reached, followed by menotropin (HMG), e.g. Menogen: 1-2 ampoules 3 times a week for several months.
- Alternatively: substitution therapy with GnRH (half-life of a few minutes) is possible via automatic infusion pumps. Antiestrogens (e.g. tamoxifen, 2 times 10 mg/day p.o.) bind competitively to glucocorticoid receptors in the hypothalamus and can lead to an increase in GnRH levels and rise in FSH and LH.
LiteratureThis section has been translated automatically.
- Igawa K et al (2003) Leg ulcer in Klinefelter's syndrome. J Eur Acad Dermatol Venereol 17: 62-64
- Kobayashi T et al (2002) Adult-onset idiopathic hypogonadotropic hypogonadism presented with erectile and ejaculatory disorder. Int J Urol 9: 604-606
- Partsch EM et al (1988) Pathophysiology of secondary testicular dysfunctions. dermatologist 39: 767-772
- Silveira LF et al (2002) Hypogonadotropic hypogonadism. Semin Reprod Med 20: 327-338