Undescended and Cryptorchid Testes

Embryology
  • John M. Hutson
  • Suzanne Hasthorpe

Abstract

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.

Keywords

Migration Estrogen Testosterone Polypeptide Resid 

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References

  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

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