***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: A double-blind , placebo-controlled study of the efficacy of LH-RH nasal spray in treatment of cryptorchidism involving 252 prepuberal boys with 301 undescended testes , showed a success rate of 9 % ( 14 testes ) for LH-RH and 8 % ( 10 testes ) for placebo . Including a subsequent open study and a second course of LH-RH as required , the rate for  LH-RH  rose to 18 % ( 48 testes ) . The follow-up period saw late descent in another 5 % ( 14 testes ) , in a few cases coinciding with the onset of puberty . Retrospective evaluation revealed a previous scrotal position of the testes for 43 % of the boys with success of treatment and even for 17 % of the boys with failure of treatment . In many of these cases surgery revealed an anatomical anomaly that might have caused testicular ascent . Hormonal evaluation revealed no abnormalities in cryptorchid boys  compared with control subjects , nor was there a divergence in values before and after treatment . The lower the pretreatment testicular position , the better the rate of success OBJECTIVE To compare  orchiopexy  by laparoscopy versus traditional surgical technique in patients with an undescended palpable testicle in the inguinal canal . MATERIAL S AND METHODS A prospect i ve , comparative , observational , longitudinal , and double-blind research was done between August 2006 and March 2009 in the Centro de Especialidades Médicas del Estado de Veracruz , " Dr. Rafael Lucio " ; 63 patients underwent surgery , age 1 - 10 years , all with the diagnosis of palpable undescended testicle in the inguinal canal ; in 33 patients , the traditional surgical technique and in 30 patients laparoscopy were done . A visual analogue scale ( VAS ) was used to evaluate post-surgery pain . A testicle ultrasound was practice d before surgery and at 6 months after it . RESULTS The majority of patients were 1 - 4 years old with a median age of 2.3 years ; 51 cases were unilateral and 12 cases were bilateral ; 37 testicles were descended with the open traditional surgical technique and 38 through laparoscopy ( 75 testicles ) ; 44 on the right side and 31 on the left side ; there was a hernia associated with 37 undescended testicles , 23 with open surgical technique , and 14 by laparoscopy , without relapsing in any patient . The median surgery time with the open surgical technique was 38 minutes and by laparoscopy , it was 45 minutes . The gobernaculum testis was sectioned by laparoscopy in 23 descended testicles to facilitate the procedure , in the remaining 11 it was not necessary ; whereas in the open technique , all the gobernaculum testis were sectioned . In 80 % of cases , the laparoscopy caused less pain when compared with the other technique . All patients regardless of the technique used left hospital during the first 24 hours . All have had follow-up for more than 6 months with a median of 18 months , with satisfactory results in relation to size and location of the testicle , with a good ultrasound correlation , and not finding any statistical differences between surgical techniques . There were no accidents with any of the techniques , and 1 patient with the open technique had an important hematoma ; hemophilia was later diagnosed in the patient . The esthetical aspect was better with laparoscopy , but the cost was 15 % more expensive with the open technique . CONCLUSIONS Both techniques had satisfactory results without any significant differences to make us choose one over the other . It is the surgeons ' decision based on experience and training on laparoscopy to choose any of the techniques INTRODUCTION Infertility is the primary concern for boys with uni- or bilateral undescended testes . An early and seemingly successful orchiopexy does not improve fertility in a substantial number of cryptorchid males . We confirmed that LH-RH analogue ( LH-RHa ) treatment induces an increase in and maturation of the germ cells ; however , it was uncertain if treatment would improve the chance of fertility later in life . MATERIAL S AND METHODS Thirty unilateral cryptorchid boys , with an average age of 3 years at the time of surgery , were included in the study . Testicular biopsy showed that they had impaired testicular maturation and were therefore at high risk for infertility . Fifteen of the 30 unilateral cryptorchid boys were treated with 10 microg LH-RHa ( Buserelin ) nasal spray , administered on alternate days for a period of 6 months , following orchiopexy . The control group consisted of 15 cryptorchid boys who had been treated by Schoemakers type of orchiopexy , alone . After puberty , the ejaculates of both groups were analyzed . RESULTS All males in the untreated group were severely oligospermic , with 20 % being azoospermic . In contrast , 86 % of the treated ex-cryptorchid males had a sperm concentration within the normal range ; this was significantly different from the sperm concentration found in the untreated group ( p=0.000008 ) . CONCLUSION For the first time , we demonstrate that infertility in cryptorchidism can be successfully corrected when suitably treated with a LH-RHa .  Sperm parameters normalized following therapy in the majority of cryptorchid males who , untreated , would have remained infertile . This innovative hormonal treatment will have a profound effect on the current recommended surgical treatment of boys with undescended testes Two courses of LHRH nasal spray ( 400 micrograms three times a day for 28 days ) , partly administered in a double-blind placebo-controlled study , result ed in the descent of 48 of 281 testes ( 18 % ) in 237 prepuberal boys . Logistic regression analysis confirmed the clinical observation that pretreatment testicular position was the major factor influencing treatment results : the lower the pretreatment testicular position , the better the result . Of the unsuccessfully treated boys , 170 with 196 undescended testes subsequently underwent orchiopexy revealing anatomic anomalies that accounted for failure of hormonal treatment in 80 % of the cases . Most frequent finding amounted to an underdeveloped processus vaginalis , extending no further than the level of the pubic bone , often associated with major epididymal deformities and a lack of obliteration of the processus vaginalis ( 107 of 196 operations ) . Obstruction of the scrotal entrance due to abnormal Scarpa 's fascia or abnormal gubernacular remnant was found in 35 and testicular absence in 15 cases . LHRH nasal spray might be effective when the testis can be manipulated to at least the scrotal entrance before treatment , but in view of our surgical findings , LHRH nasal spray will not replace orchiopexy This r and omized double-blind placebo-controlled study was initiated to analyze the behavior of epididymis , processus vaginalis and testicular descent in cryptorchid boys treated with a low dose ( 20 μg ) of a  luteinizing hormone-releasing hormone analogue ( Buserelin ) , administered daily , as a nasal spray , for a short period ( 28 days ) . Fifty-nine true cryptorchid boys were r and omly assigned to 3 groups : buserelin , treatment [ 22 ] , surgical treatment [ 18 ] or placebo control group [ 19 ] . The 3 groups of patients were similar before treatment in regard to testicular position , chronological and bone age , height and weight , luteinizing hormone , follicle-stimulating hormone , testosterone , penile size and the volume of the contralateral descended testis . None of the patients had retractile testes . Buserelin significantly induced testicular descent compared to the boys treated with a placebo ( P<0.01 ) . A normal epididymis was found more often in boys with successful descent ( P<0.003 ) . A closed processus vaginalis was also more frequently observed in the group treated with buserelin than in surgically treated one ( P<0.05 ) . In conclusion , buserelin was capable of inducing testicular descent besides provoking further development of the epididymis and closing the processus vaginalis The effect of intranasal , synthetic LH-RH ( Hoe 471 ) on  undescended testes  was investigated in : I. a double blind study comprising 50 patients given either placebo or 0.6 mg LH-RH daily and II . an open study comprising 50 patients with a daily dosage of 1.2 mg LH-RH .  In both studies LH-RH was given for 4 weeks . Since some patients had bilateral undescended testes , 116 testes were treated in total . Patients ' ages varied between 11/2 and 101/2 years , with a mean of 5 years . Clinical examination before , during and at end of treatment was performed by both the authors independently . In the placebo group , one testicular descent was seen , indicating difficulty in diagnosis . A therapeutic result , i.e. a significant move from the pretreatment location towards the bottom of the scrotum was seen in 60 % of the testes , complete descent being seen in about 40 % . In a follow-up study 6 months after treatment , in 23 cases with complete descent from a pretreatment inguinal position , relapse was seen in 5 patients ( 2 were located at scrotal neck , 3 at the pretreatment position i.e. inguinal ) . The best results were seen on testes located not too far from the scrotal neck , with the higher dosage of LH-RH and in patients less than 6 years of age . No significant hormonal changes ( testosterone-,LH-or FSH-levels in peripheral blood ) were seen during the study . Side effects were negligible Purpose We prospect ively evaluated the surgical outcomes of single scrotal incision orchiopexy in children with a palpable undescended testis compared with the traditional two incision orchiopexy . Material s and Methods A total of 398 orchiopexies ( 292 children ) were included and r and omly assigned to the  single scrotal incision orchiopexy group  ( Group I , 147 children , 201 testes ) or the  traditional inguinal incision orchiopexy group  ( Group II , 145 children , 197 testes ) . The final number of patients enrolled ( excluding those lost to follow-up ) was 107 children ( 146 testes ) in group I and 105 children ( 141 testes ) in group II . Success was defined as no complications , postoperative intrascrotal location of the testis , and no conversion to the traditional inguinal approach . Surgical outcomes and complications were compared between the two groups . Testicular location , complications , and subjective satisfaction rate were assessed at the follow-up evaluation at least 12 months postoperatively . Results The overall success rate in group I was 92.5 % in 135 of 146 testes ; the remaining 9 testes required conversion to traditional two incision orchiopexy . In group II , orchiopexy was successful in 136 of 141 testes ( 96.5 % ) . The operation time and hospital stay were significantly shorter in group I ( 40.5±25.9 minutes , 2.1±0.8 days ) than in group II ( 62.3±35.6 minutes , 2.5±0.7 days ) , respectively ( p<0.001 , p=0.03 ) . Postoperative complications were found in two cases ( hematoma , wound dehiscence ) in group I and in one case ( wound dehiscence ) in group II ; all cases with complications recovered with conservative care . The subjective rate of satisfaction with the cosmetic result was 96.6 % in group I and 96.5 % in group II ( p=0.97 ) . Conclusions We conclude that single scrotal incision orchiopexy is a simple technique that is associated with a shorter operation time and hospital stay than the traditional method and that is more feasible cosmetically Fifty unilaterally cryptorchid boys aged 3 to 8 years were r and omly and blindly allocated to treatment with luteinizing hormone releasing hormone or placebo intranasally . In the treated group , no significant descent of the undescended testis was found , whereas a minor downward movement of the scrotal testis occurred ( P less than 0.001 ) , probably as a result of decreased retraction by the cremaster muscle . Basal serum testosterone concentrations and testicular volume increased after treatment ( P less than 0.01 and P less than 0.001 , respectively ) . The response to an acute LHRH test , 100 micrograms/m2 body surface IV , before and after treatment , showed an increase in the luteinizing hormone peak value and a decrease in the follicle-stimulating hormone response in a significant number of patients ( P less than 0.001 ) . In the individual patient , there was a positive correlation between the increase in basal serum testosterone concentration and the degree of downward movement of the undescended testis ( P less than 0.05 ) PURPOSE Laparoscopic assessment of pelvic anatomy has gained wide popularity over the years . Today surgical treatment of impalpable testis is nearly always preceded by diagnostic laparoscopy . The actual role of such a procedure remains undefined . We performed a prospect i ve r and omized clinical trial in patients with impalpable testis to evaluate the clinical usefulness of laparoscopy before surgical exploration . MATERIAL S AND METHODS We studied pediatric , age matched patients with impalpable testis who were r and omized to group 1 - 30 who underwent open surgery only and group 2 - 31 who under 
    Output:
    
Descent rates were similar among studies comparing laparoscopic and open surgeries .
Reported harms of hormonal treatments were mild and transient .
Adverse effects specifically associated with surgical repair were rare .
Hormonal treatment is marginally effective relative to placebo but is successful in some children and with minimal harms , suggesting that it may be an appropriate trial of care for some patients .
Surgical options are effective , with high rates of testicular descent ( moderate strength of evidence for FS procedures , high for primary orchiopexy ) .
Comparable outcomes occur with laparoscopic and open approaches