Therapeutic effects of a pulsatile GnRH pump on adult male patients with congenital hypogonadotropic hypogonadism (CHH): a retrospective study.

IF 1.7 3区医学 Q4 ANDROLOGY

Translational andrology and urology Pub Date : 2025-07-30 Epub Date: 2025-07-28 DOI:10.21037/tau-2025-199

Hao Jiang, Bo-Jun Li, Da-Chun Jin, Qu-Liang Zhong, Tong Zhu, Yan-Feng Li

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引用次数: 0

Abstract

Background: Traditional treatments for congenital hypogonadotropic hypogonadism (CHH) primarily focus on human chorionic gonadotropin (hCG) monotherapy, combined gonadotrophin treatment or Testosterone replacement therapy, which has certain limitations in effectiveness. In recent years, pulsatile gonadotropin-releasing hormone (GnRH) pump treatment, capable of mimicking physiological hormone release patterns, has become a more preferred treatment option. However, there is still a scarcity of medium- and long-term studies in this regard. This study aimed to evaluate the medium- and long-term efficacy of pulsatile GnRH on CHH patients by a microinfusion pump, and to assess the varied effects exhibited in subgroups of CHH patients.

Methods: We analyzed the clinical data from 54 adult male CHH patients who were treated with pulsatile GnRH pumps. Clinical patient parameters included morphology and size of the external genitalia, sex hormone concentrations, and fertility-evaluated before and at 6, 12, and 24 months of treatment.

Results: The mean follow-up time was 15.9 (range, 3-40) months. The mean testicular volume [6.22±1.85 (mean ± standard deviation), 8.90±2.36, 9.73±1.93 mL], serum testosterone level (T) (234±143, 361±117, 381±68 ng/dL), flaccid penile length (4.77±0.68, 5.70±0.69, 6.08±0.52 cm), and stretched penile length (7.87±1.01, 9.44±1.24, 9.63±1.07 cm) of the CHH patients after 0.5, 1, and 2 years of treatment, respectively, were significantly increased compared with the same parameters before treatment (3.19±1.66 mL, 48±47 ng/dL, 3.54±0.92 cm, 5.68±1.27 cm, respectively) (P<0.01). The size of the external genitalia and serum T level of the patients after 1 and 2 years of treatment were further improved when compared with 0.5 year of treatment (P<0.01). Thirty-four of the 45 patients who had over 0.5 year of treatment successfully collected their semen and 27 men produced spermatozoa. CHH patients with normal olfaction, younger patients, and those with initial testicular volumes greater than 4 mL had a faster onset and better outcomes.

Conclusions: The use of a GnRH pulsatile pump comprises a strategy with long-term beneficial effects for the treatment of adult male CHH.

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脉冲式GnRH泵治疗成年男性先天性促性腺功能低下（CHH）的疗效：回顾性研究。

背景：先天性促性腺功能减退症（CHH）的传统治疗主要以人绒毛膜促性腺激素（hCG）单药治疗、促性腺激素联合治疗或睾酮替代治疗为主，其疗效存在一定局限性。近年来，脉动式促性腺激素释放激素（GnRH）泵治疗，能够模仿生理激素释放模式，已成为更首选的治疗方案。然而，这方面的中长期研究还比较缺乏。本研究旨在通过微输注泵评估脉动GnRH对CHH患者的中长期疗效，并评估CHH患者亚组中表现出的不同效果。方法：我们分析54例成年男性CHH患者的临床资料，这些患者采用搏动式GnRH泵治疗。临床患者参数包括外生殖器的形态和大小、性激素浓度和生育能力——在治疗前、6个月、12个月和24个月时进行评估。结果：平均随访时间15.9个月，范围3 ~ 40个月。治疗0.5年、1年、2年后CHH患者的平均睾丸体积[6.22±1.85（平均±标准差）、8.90±2.36、9.73±1.93 mL]、血清睾酮水平(T)（234±143、361±117、381±68 ng/dL）、松弛阴茎长度（4.77±0.68、5.70±0.69、6.08±0.52 cm）、拉伸阴茎长度（7.87±1.01、9.44±1.24、9.63±1.07 cm）均较治疗前（3.19±1.66 mL、48±47 ng/dL、3.54±0.92 cm、5.68±1.27 cm）显著升高。结论：使用GnRH脉冲泵治疗成年男性CHH是一种长期有益的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational andrology and urology Medicine-Urology

CiteScore

4.10

自引率

5.00%

发文量

期刊介绍： ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.