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OBJECTIVE To test the hypothesis that men with a history of undescended testicle have voiding problems similar to those in rodents exposed to excessive amounts of oestrogens during development, although the role of oestrogen in the failure of the human testicle to descend remains controversial. PATIENTS AND METHODS Thirteen men (mean age 45 years) previously operated on for an undescended testicle (testis-retention, TR group) and 12 age-matched men operated on for inguinal hernia or appendicitis (control group) participated in a urodynamic examination, transrectal ultrasonography (TRUS) of the prostate, and blood tests for hormones and prostate-specific protein. They also completed a questionnaire on urinary symptoms. RESULTS The free maximum flow rate was significantly lower and the detrusor pressure at maximum flow (PdetQmax) slightly higher in the TR than the control group. Three men in the TR group (and none of the controls) had bladder outlet obstruction (BOO), whereas voiding was not obstructed among 11 control men (and five men in the TR group). The hormone concentrations of the groups did not differ significantly but the prostates were significantly smaller in the TR group. The testosterone concentrations and the ratio between 17β-oestradiol (E2) and free testosterone (E2/fT) influenced prostate size significantly. An exploratory analysis suggested that E2/fT may influence the maximum detrusor pressure and PdetQmax. CONCLUSION Men born with an undescended testicle had smaller prostates but more often had BOO than did the controls. The results suggest that an imbalance between the actions of oestrogen and testosterone may influence the initiation and continuance of BOO among cryptorchid men.

Explants of the ventral prostate of adult rats, were maintained in organ culture with various steroids and insulin. In addition to androgens glucocorticoids and insulin were necessary for the maximal stimulation of the explants as judged by measuring the incorporation of labeled precursors into DNA, RNA and protein and the formation of 14CO2 from 1FC-glucose by explants. The addition of cyproterone, a steroid with high antiandrogenic potency to the culture medium suppressed the testosterone action, but did not interfere withthe effects of insulin. These findings were taken as a proof of the direct and specific antiandrogenic action of cyproterone on the rat prostate.

The effect of various steroids and insulin on expiants of the ventral prostate of adult rats in organ culture was investigated. Testosterone activated the incorporation of labeled precursors into RNA and protein and the formation of 14CO2 from 14C-glucose by expiants. All these effects were mimiced by insulin. The testosterone action was suppressed by cyproterone in vitro. In addition to androgens, glucocorticoids activated the incorporation of 3H-uridine into RNA. Simultaneous addition of testosterone with hydrocortisone or insulin produced an augmented effect on the incorporation of 3H-uridine into RNA which exceeded that resulting from a simple summation of the individual hormone responses. Insulin facilitated likewise the action of testosterone on the incorporation of 14C-amino acids into protein. When all three hormones were added simultaneously to the culture medium the stimulation of the three biochemical parameters was maximal. It was therefore concluded that all three hormones are necessary for an adequate maintenance of the ventral prostate of the rat.