Advertisement

Embryology of Prepuce

  • Mohamed A. Baky Fahmy
Chapter
  • 239 Downloads

Abstract

The embryology of the penis and urogenital region had been controversial and confusing for long time before evolving of recent studies, which emerged extensively during the last decade. The other problem in the previous studies that most of the observations have been extrapolated to the human from many different other species including mice, rats, red squirrels and pigs, and this may leads to misinterpretation of many aspects. At the main time the embryology of the prepuce was not considered earnestly among the genital embryology in the old textbooks. Fetal sex development involves a series of sequential stages, and both differentiation and formation of internal and external genitalia are a late-developmental steps in human ontogeny which are regulated by the action of sex hormones. The human prepuce is formed by a midline collision of ectoderm, neuroectoderm and mesenchyme, resulting in a pentalaminar sheath. The first indication of the onset of the developmental processes of the prepuce involved the appearance of a raised fold (the preputial fold), just at the coronary sulcus. At the same time the floor of the resulting glandopreputial furrow gives rise to a lamellar ingrowth which has been termed “glandar lamella”, these lamella grow gradually to cover the dorsum of the glans and then fuse ventrally to form the frenulum at the midline, the ventral surface of the glans is the last part of the penis to be covered by foreskin, so deficient perpetual development usually results in defective ventral prepuce as in cases of hypospadias and some cases of microposthia. The glans was partially covered by the foreskin only in the fetus at 13 weeks. Prepuce completely covering and fusing with the glans structure at around twenty-fourth week of gestation. It is generally accepted that normal preputial development is required for successful canalization of the glandular urethra, so the absence of the prepuce would result in an abnormal development of this part of urethra, and to be manifested as a hypospadias with a usual hooded prepuce.

Keywords

Genital tubercle Pentalaminar sheath Glandopreputial membrane 

Abbreviations

AR

Androgen receptor

DHT

Dihydrotestosterone

GT

Genital tubercle

wpc

Weeks post conceptional

References

  1. 1.
    Bokai J. A fityma (preputium) seites adatapadasa a makkoe gyermakelnel. Orv Heill. 1860;4:583–7.Google Scholar
  2. 2.
    Schweigger-Seidel F. Zur Entwickelung des Praeputium. Virchows Archiv. 1866;37:219–28.CrossRefGoogle Scholar
  3. 3.
    Glenister TW. A consideration of the process involved in the development of the prepuce in man. Br J Urol. 1956;28:243–9.CrossRefGoogle Scholar
  4. 4.
    Baskin L, Shen J, Sinclair A, Cao M, Liu X, Liu G, Isaacson D, Overland M, Li Y, Cunha J. Development of the human penis and clitoris. Differentiation. 2018;103:74.CrossRefGoogle Scholar
  5. 5.
    Isaacson D, Shen J, Overland M, Li Y, Sinclair A, Cao M, McCreedy D, Calvert M, McDevitt T, Cunha GR, Baskin L. Three-dimensional imaging of the developing human fetal urogenital-genital tract: indifferent stage to male and female differentiation. Differentiation. 2018;103:14.  https://doi.org/10.1016/j.diff.2018.09.003.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Renfree MB, Wilson JD, Shaw G. The hormonal control of sexual development. Novartis Found Symp. 2002;244:136–52; discussion 152–136, 203–136, 253–137.PubMedGoogle Scholar
  7. 7.
    Hadidi AT, Roessler J, Coerdt W. Development of the human male urethra: a histochemical study on human embryos. J Pediatr Surg. 2014;49(7):1146–52.CrossRefGoogle Scholar
  8. 8.
    Hadidi AT. Normal development of the penis and urethra. In: Carachi R, Doss S, editors. Clinical embryology. Cham: Springer; 2019.  https://doi.org/10.1007/978-3-319-26158-4_44.CrossRefGoogle Scholar
  9. 9.
    Gleniste TW. A consideration of the processes involved in the development of the prepuce in man. Br J Urol. 1956;28:243–9.CrossRefGoogle Scholar
  10. 10.
    Liu X, Liu G, Shen J, Yue A, Isaacson D, Sinclair A, Cao M, Liaw A, Cunha GR, Baskin L. Human glans and preputial development. Differentiation. 2018;103:86.  https://doi.org/10.1016/j.diff.2018.08.002.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Kayaba H, Tamura H, Kitajima S, Fujiwara Y, Kata T, Kata T. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol. 1996;156:1813–5.CrossRefGoogle Scholar
  12. 12.
    Goto M, et al. In humans, early cortisol biosynthesis provides a mechanism to safeguard female sexual development. J Clin Invest. 2006;116(4):953.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Mohamed A. Baky Fahmy
    • 1
  1. 1.Pediatric SurgeryAl Azher UniversityCairoEgypt

Personalised recommendations