Undescended and Cryptorchid Testes

  • John M. Hutson
  • Suzanne Hasthorpe


The testes develop in the abdominal cavity as part of the urogenital ridge. The prenatal descent from their initial intra-abdominal position to the scrotum requires the formation of the inguinal canal as a way of allowing the testes to exit from the abdominal cavity. Hence, the process of testicular descent is ultimately the cause of inguinal hernias.


Inguinal Hernia Inguinal Canal Undescended Testis Testicular Descent Genitofemoral Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bedford JM. Anatomical evidence for the epididymis as the prime mover in the evolution of the scrotum. Am J Anat. 1978;152:483–508.PubMedCrossRefGoogle Scholar
  2. 2.
    Mieusset R, Fonda PJ, Vaysse P, et al. Increase in testicular temperature in case of cryptorchidism in boys. Fertil Steril. 1993;59:1319–1321.PubMedGoogle Scholar
  3. 3.
    Hutson J, Williams MPL, Fallat ME, et al. Testicular descent: new insights into its hormonal control. Oxf Rev Reprod Biol. 1990;12:1–56.PubMedGoogle Scholar
  4. 4.
    Kurian MS, Sainz de la Cuesta R, Waneck GL, et al. Cleavage of Mullerian inhibiting substance activates antiproliferative effects in vivo. Clin Cancer Res. 1995;1:343–349.PubMedGoogle Scholar
  5. 5.
    Backhouse KM. The natural history of testicular descent and maldescent. Proc Roy Soc Med. 1966;59:357–360.PubMedGoogle Scholar
  6. 6.
    van der Schoot P, Elger W. Androgen-induced prevention of the outgrowth of the cranial gonadal suspensory ligaments in foetal rats. J Androl. 1992;13:534–542.PubMedGoogle Scholar
  7. 7.
    Tran D, Picard JY, Vigier B, et al. Persistence of Mullerian ducts in male rabbits passively immunized against bovine anti-Mullerian hormone during fetal life. Dev Biol. 1986;116:160–167.PubMedCrossRefGoogle Scholar
  8. 8.
    Fentener van Vlissingen MF, van Zoelen EJJ, Ursem PJF, et al. In vitro model of the first phase of testicular descent: identification of a low molecular weight factor from fetal testis involved in proliferation of gubernaculum testis cells and distinct from specified polypeptide growth factors and fetal gonadal hormones. Endocrinology. 1988;123: 2868–2877.PubMedCrossRefGoogle Scholar
  9. 9.
    Behringer RR, Finegold MJ, Cate RL. Mullerian-inhibiting substance function during mammalian sexual development. Cell. 1994;79:415–425.PubMedCrossRefGoogle Scholar
  10. 10.
    Langer R. Controlled release of a therapeutic protein. Nat Med. 1996; 2:742–743.PubMedCrossRefGoogle Scholar
  11. 11.
    Shono T, Ramm-Anderson S, Hutson JM. Transabdominal testicular descent is really ovarian ascent. J Urol. 1994;152:781–784.PubMedGoogle Scholar
  12. 12.
    Backhouse KM. The gubernaculum testis Hunteri: testicular descent and maldescent. Ann Roy Coll Surg Engl. 1964;35:15–33.Google Scholar
  13. 13.
    Goh DW, Middlesworth W, Momose Y, et al. Prenatal androgen blockade with flutamide inhibits masculinisation of the genitofemoral nerve and testicular descent. J Pediatr Surg. 1994;29:836–838.PubMedCrossRefGoogle Scholar
  14. 14.
    Goh DW, Momose Y, Middlesworth W, et al. The relationship among CGRP, androgens and gubernacular development in three animal models of cryptorchidism. J Urol. 1993;150:571–573.PubMedGoogle Scholar
  15. 15.
    Momose Y, Griffiths AL, Hutson JM. Testicular descent III. The neonatal mouse gubernaculum shows rhythmic contraction in organ culture in response to calcitonin gene-related peptide (CGRP). Endocrinology. 1992;131:2881–2884.PubMedCrossRefGoogle Scholar
  16. 16.
    Terada M, Hutson JM, Farmer PJ, et al. The role of the genitofemoral nerve and CGRP in congenitally cryptorchid mutant TS rats. J Urol. 1995;154:734–737.PubMedCrossRefGoogle Scholar
  17. 17.
    Griffiths AL, Hutson JM. Testicular descent I. The role of estrogen in gubernacular migration in inguino-scrotal testicular descent. Pediatr Surg Int. 1993;8:322–328.CrossRefGoogle Scholar
  18. 18.
    Yamanaka J, Metcalfe SA, Hutson JM, et al. Testicular descent II. Ontogeny and response to denervation of calcitonin gene-related peptide receptors in neonatal rat gubernaculum. Endorcrinology. 1993;132: 1–5.Google Scholar
  19. 19.
    Hunter J. A description of the situation of the testis in the foetus, with its descent into the scrotum. In: Hunter J, ed. Observations on certain parts of the animal oeconomy. London: 13 Castle St.; 1978:1–26.Google Scholar
  20. 20.
    Mitchell GAG. The condition of the peritoneal vaginal process at birth. J Anat. 1939;73:658–661.PubMedGoogle Scholar
  21. 21.
    Scorer CG. The anatomy of testicular descent—normal and incomplete. Br J Surg. 1962;49:357–367.PubMedCrossRefGoogle Scholar
  22. 22.
    Atwell JD. Inguinal herniae and the testicular feminization syndrome in infancy and childhood—case report and review of the literature. Br J Surg. 1962;49:367–371.PubMedCrossRefGoogle Scholar
  23. 23.
    Bica DTG, Hadziselimovic F. The behavior of epididymis, processus vaginalis and testicular descent in cryptorchid boys treated with buserelin. Eur J Pediatr 1993;152:S38–S42.PubMedCrossRefGoogle Scholar
  24. 24.
    Johansen TEB, Klein H. Evidence of androgen receptivity in the pathway of testicular descent in humans. Eur Urol. 1993;23:466–468.PubMedGoogle Scholar
  25. 25.
    Hutson JM, Albano FR, Paxton G, et al. In vitro fusion of human hernia with associated epithelial transformation. Acta Anat. 2000; 166: 249–258.CrossRefGoogle Scholar
  26. 26.
    Hutson JM, Beasley SW. Descent of the testis. London: Edward Arnold; 1992:1–87.Google Scholar
  27. 27.
    Scorer CG, Forrest DM, Dennison WM, et al. Undescended testicle. BMJ. 1960;1359.Google Scholar
  28. 28.
    Hadziselimovic F, Herzog A, Girard J, et al. Cryptorchidism—histology, fertility and treatment. Prog Reprod Biol Med. 1984;10:1–15.Google Scholar
  29. 29.
    Hadziselimovic F, Herzog A, Girard J. Impaired interuterine gonadotropin secretion as an etiological component of cryptorchidism. Pediatr Res. 1976;10:883.CrossRefGoogle Scholar
  30. 30.
    Josso N, Picard J-Y, Imbeaud S, et al. Clinical aspects and molecular genetics of the persistent Mullerian duct syndrome. Clin Endocrinol. 1997;47:137–144.CrossRefGoogle Scholar
  31. 31.
    Hutson JM, Chow CW, Ng W-D. Persistent Mullerian duct syndrome with transverse testicular ectopia. Pediatr Surg Int. 1987;2:191–194.Google Scholar
  32. 32.
    Wigger HJ, Blanc WA. The prune belly syndrome. Pathol Annu. 1977; 1:17–39.Google Scholar
  33. 33.
    Pagon RA, Shepard TH. Urethral obstruction malformation complex: a cause of abdominal muscle deficiency and the “prune belly.” J Pediatr. 1979;94:900–906.PubMedCrossRefGoogle Scholar
  34. 34.
    Hadziselimovic F, Duckett JW, Snyder III HM, et al. Omphalocele, cryptorchidism, and brain malformations. J Pediatr Surg. 1987;22:854–856.PubMedCrossRefGoogle Scholar
  35. 35.
    Hutson JM, Beasley SW, Bryan AD. Cryptorchidism in spina bifida and spinal cord transection: a clue to the mechanism of transinguinal descent of the testis. J Pediatr Surg. 1988;23:275–277.PubMedCrossRefGoogle Scholar
  36. 36.
    Hutson JM, Goh DW. Can undescended testes be acquired? Lancet. 1993;341:504.PubMedCrossRefGoogle Scholar
  37. 37.
    Clarnette TD, Rowe D, Hasthorpe S, et al. Incomplete disappearance of the processus vaginalis as a cause of ascending testis. J Urol. 1997; 157:1889–1891.PubMedCrossRefGoogle Scholar
  38. 38.
    Smith A, Hutson JM, Beasley SW, et al. The relationship between cerebral palsy and cryptorchidism. J Pediatr Surg. 1989;24:1303–1305.PubMedCrossRefGoogle Scholar
  39. 39.
    Clarnette TD. Is the ascending testis actually “stationary”? Pediatr Surg Int. 1997;12:155–157.CrossRefGoogle Scholar
  40. 40.
    Gendrel D, Roger M, Job J-C. Plasma gonadotropin and testosterone values in infants with cryptorchidism. J Pediatr. 1980;97:217–220.PubMedCrossRefGoogle Scholar
  41. 41.
    Job JC, Toublanc JE, Chaussain JL, et al. Endocrine and immunological findings in cryptorchid infants. Horm Res. 1988;30:167–172.PubMedCrossRefGoogle Scholar
  42. 42.
    Brown TR, Berkovitz GD, Gearhart JP. Androgen receptors in boys with isolated bilateral cryptorchidism. AJDC. 1988;142:933–936.PubMedGoogle Scholar
  43. 43.
    Yamanaka J, Baker JL, Metcalfe S, et al. Serum levels of Mullerian inhibiting substance in boys with cryptorchidism. J Pediatr Surg. 1991; 26:621–623.PubMedCrossRefGoogle Scholar
  44. 44.
    Orvis BR, Bottles K, Kogan BA. Testicular histology in fetuses with the prune belly syndrome and posterior urethral valves. J Urol. 1988; 139: 335–337.PubMedGoogle Scholar
  45. 45.
    Huff DS, Hadziselimovic F, Snyder III HM, et al. Early postnatal testicular maldevelopment in cryptorchidism. J Urol. 1991;146:624–626.PubMedGoogle Scholar
  46. 46.
    Huff DS, Hadziselimovic F, Snyder III HM, et al. Histologic maldevelopment of unilaterally cryptorchid testes and their descended partners. Eur J Pediatr. 1993;152:S10–S14.CrossRefGoogle Scholar
  47. 47.
    Zhou B, Watts LM, Hutson JM. Germ cell development in neonatal mouse testes in vitro requires Mullerian inhibiting substance. J Urol. 1993;150:1–4.Google Scholar
  48. 48.
    Hutson JM. Undescended testes. In: Stringer MD, Mouriquand PDE, Oldham KT, Howard ER, eds. Pediatric surgery and urology: long-term outcomes. London: W.B. Saunders; 1998:603–615.Google Scholar
  49. 49.
    Giwercman A, Muller J, Skakkebaek NE. Carcinoma in situ of the testis: possible origin, clinical significance, and diagnostic methods. Recent Results Cancer Res. 1991;123:21–36.PubMedCrossRefGoogle Scholar
  50. 50.
    Beltran-Brown F, Villegas-Alvarez F. Clinical classification for undescended testes: experience in 1,010 orchidopexies. J Pediatr Surg. 1988;23:444–447.PubMedCrossRefGoogle Scholar
  51. 51.
    Hadziselimovic F. Hormonal treatment of cryptorchidism. New Engl J Med. 1986;322.Google Scholar
  52. 52.
    Hadziselimovic F. Hormonal treatment of the undescended testis. J Pediatr Endocrinol 1987;2:1–5.Google Scholar
  53. 53.
    De Muinck Keizer-Schrama SMPF, Hazebroek FWJ, Drop SLS, et al. Double-blind, placebo-controlled study of luteinising hormone-releasing hormone nasal spray in treatment of undescended testes. Lancet. 1986;876–879.Google Scholar
  54. 54.
    Rajfer J, Handelsman DJ, Swerdloff RS, et al. Hormonal therapy of cryptorchidism. A randomized, double-blind study comparing human chorionic gonadotropin and gonadotropin-releasing hormone. New Engl J Med. 1986;314:466–470.PubMedCrossRefGoogle Scholar
  55. 55.
    Bellinger MF, Abromowitz H, Brantley S, et al. Orchiopexy: an experimental study of the effect of surgical technique on testicular histology. J Urol. 1989;142;553–555.PubMedGoogle Scholar
  56. 56.
    Swerdlow AJ, Higgins CD, Pike MC. Risk of testicular cancer in cohort of boys with cryptorchidism. BMJ. 1997;314:1507–1511.PubMedCrossRefGoogle Scholar
  57. 57.
    Humphrey GME, Najmaldin AS, Thomas DFM. Laparoscopy in the management of the impalpable undescended testis. Br J Surg. 1998;85: 983–985.PubMedCrossRefGoogle Scholar
  58. 58.
    Cisek LJ, Peters CA, Atala A, et al. Current findings in diagnostic laparoscopic evaluation of the nonpalpable testis. J Urol. 1998; 160:1145–1149.PubMedCrossRefGoogle Scholar
  59. 59.
    King LR. Orchiopexy for impalpable testis: high spermatic vessel division is a safe manoeuver. J Urol. 1998;160:2457–2460.PubMedCrossRefGoogle Scholar
  60. 60.
    Gracia J, Navarro E, Guirado F, et al. Spontaneous ascent of the testis. Br J Urol. 1996;79:113–115.Google Scholar
  61. 61.
    Barthold JS, Mahler HR, Sziszak TJ, et al. Lack of feminization of the cremaster nucleus by prenatal flutamide administration in the rat and pig. J Urol. 1996;156:767–771.PubMedCrossRefGoogle Scholar
  62. 62.
    Bianchi A, Squire BR. Transscrotal orchidopexy: orchidopexy revised. Pediatr Surg Int. 1989;4:189–192.CrossRefGoogle Scholar
  63. 63.
    Wilson-Storey D, McGenity K, Dickson JAS. Orchidopexy: the younger the better? J Roy Coll Surg Edinb. 1990;35:362–364.PubMedGoogle Scholar
  64. 64.
    Pike MC, Chilvers C, Peckham MJ. Effect of age at orchidopexy on risk of testicular cancer. Lancet. 1986; 1246–1248.Google Scholar
  65. 65.
    Lee PA, Bellinger MF, Couglin MT. Correlations among hormone levels, sperm parameters and paternity in formerly unilaterally cryptorchid men. J Urol. 1998;160:1155–1157.PubMedCrossRefGoogle Scholar
  66. 66.
    Davies TW, Williams DRR, Whitaker RH. Risk factors for undescended testis. Int J Epidemiol. 1986;15:197–201.PubMedCrossRefGoogle Scholar
  67. 67.
    Giwercman A, Grindsted J, Hansen B, et al. Testicular cancer risk in boys with maldescended testis: a cohort study. J Urol. 1987;138: 1214–1216.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • John M. Hutson
    • 1
  • Suzanne Hasthorpe
    • 2
  1. 1.Department of General Pédiatrie Surgery Royal Children’s Hospital Research InstituteUniversity of Melbourne, ParkvilleVictoriaAustralia
  2. 2.Surgical Research, Royal Children’s Hospital Research InstituteUniversity of Melbourne, ParkvilleVictoriaAustralia

Personalised recommendations