Hypogonadism due to testicular injury. Secondary hypogonadism in men

The causes of primary damage to the testicles with the subsequent development of signs of hypogenitalism can be testicular injuries, castration, x-ray irradiation, the effects of ionizing radiation, inflammatory changes in the testicles due to mumps, syphilis, testicular tuberculosis, damage to gonorrhea infection, testicular atrophy after inguinal hernia surgery due to circulatory disorders in them. The cause of primary hypogonadism in men may be Del Castillo syndrome – degeneration of the seminal epithelium in the presence of only Sertoli cells. 

The clinical picture of primary hypogonadism in these cases depends on in which period the damage to the testicles occurred: before or after puberty. In the first case, the absence of a sufficient amount of androgens in the body does not interfere with the enhanced growth of long tubular bones, which leads to an increase in growth and the euryuchoid proportions of the trunk. The penis is small, the testicles are small, hairiness of the pubis, axillary hollows and face is absent or scanty. Patients suffer from infertility. If the lesion of the testicles develops after puberty, then the growth and proportions of the body do not change, the potency decreases or disappears, the growth of facial hair decreases, and signs of angioneurosis may appear. As a rule, in patients with primary hypogonadism, obesity occurs with the deposition of fat according to the female type. 

Hypogonadism treatment due to testicular injury . Shown replacement therapy with male sex hormones in the form of continuous administration. In addition to drugs, subcutaneous implantations of testosterone tablets and perrandren once every 3 months are used in injections.

Secondary hypogonadism in men

Secondary hypogonadism in men occurs as a result of a violation of the correlative relationships between the hypothalamus and the anterior pituitary gland , followed by a decrease in the production of THG and androgen secretion. Cerebral-pituitary insufficiency as a result of diencephalitis, pituitary tumors, traumatic damage to it, cerebral-pituitary dwarfism can serve as a reason for the decrease in the production of THG. Signs of hypogonadism can also develop as a result of hormonal imbalance that occurs with mix-sids, diabetes mellitus (at puberty) and other diseases and is expressed in a decrease in potency and infertility (in adults) and signs of infatilism in children.   

The treatment is aimed at eliminating the underlying cause, i.e., the treatment of the underlying disease. If necessary, chorionic goyadotropin is administered in 50 units for children and 1500 units for adults 2-3 times a week for 3 months in combination with male sex hormones. With the phenomena of hypogonadism against the background of some endocrine diseases, male sex hormones are used to restore potency and improve overall well-being. 

event_note September 18, 2019

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