Effects of major surgical stress on plasma concentrations of testosterone and immunoreactive luteinizing hormone (LH) were studied in 25 male patients. Significantly decreased levels of testosterone from the pre-operative level (0.66 ± 0.03 (se) μg/100 ml) were found during the operation. On the other hand, plasma LH increased significantly from the pre-operative level [4.27 ± 0.29 (se) μg/100 ml] during the operation and reached the maximum concentration 30 min after the beginning of incision [8.28 ± 0.71 (se) μg/100 ml]. Shortly after the end of the operations, the mean concentration of LH had returned to its pre-operative level, but the mean concentration of testosterone continued to fall. No such change explainable by diurnal variation was observed in 10 male patients followed for a similar period of time prior to surgery. The patients exhibited a significant fall in LH concentration on the 2nd post-operative day [3.11 ± 0.24 (se) μg/100 ml], when plasma testosterone showed the most marked decrease [0.21 ± 0.03 (se) μg/100 ml]. Plasma levels of immunoreactive follicle-stimulating hormone examined in 9 of the 25 patients, showed no significant changes under surgical stress. These observations suggest that there may be some lack of testicular sensitivity to gonadotrophins during and following major surgery, though a shift in the androgen biosynthetic pathway of the testis may be considered.
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Aono et al. (1972) studied this question.