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Abnormalities of testicular descent

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Abstract

Testicular descent occurs in two stages. The transabdominal phase (8–15 weeks) is controlled by enlargement of the caudal genito-inguinal ligament (gubernaculum) and regression of the cranial ligament. Insulin-like 3 from the Leydig cell appears to be the prime stimulator of gubernacular growth, augmented by Müllerian inhibiting substance/anti-Müllerian hormone. Testosterone causes regression of the cranial ligament. The inguinoscrotal phase (25–35 weeks) requires the migration of the gubernaculum from the groin to the scrotum; this migration is guided by the genito-femoral nerve releasing calcitonin gene-related peptide under the influence of androgen. The neonatal gonocyte transforms into a type A spermatogonium at 3–12 months of age, a step that is now known to be crucial for subsequent fertility, as the stem cells for spermatogenesis are created in this structure. This step is blocked in undescended testis and, hence, orchidopexy is currently recommended at 6–12 months of age. Congenital cryptorchidism is caused by the failure of gubernacular migration to the scrotum (1%–2%) but we now recognise that another 1%–2% of boys have acquired cryptorchidism, secondary to the failure of spermatic cord elongation with growth of the boy. These latter cases come to operation at 5–10 years of age. Surgery remains the mainstay of treatment, as hormonal therapy has not been proven to be effective, presumably because testicular descent is a complex anatomical mechanism.

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References

  • Adham I, Steding G, Thamm T, Bullesbach EE, et al (2002) The overexpression of the Insl3 in female mice causes descent of the ovaries. Mol Endocrinol 16:244–252

    Article  PubMed  Google Scholar 

  • Beltran-Brown F, Villegras-Alvarez F (1988) Clinical classification for undescended testes: experience of 1,010 orchidopexies. J Pediatr Surg 23:444–447

    PubMed  Google Scholar 

  • Chilvers C, Dudley NE, Gough MH, et al (1986) Undescended testis: the effect of treatment on subsequent risk of subfertility and malignancy. J Pediatr Surg 21:691–696

    PubMed  Google Scholar 

  • Clarnette TD, Rowe D, Hasthorpe S, Hutson JM (1997) Incomplete disappearance of the processus vaginalis as a cause of ascending testis. J Urol 157:1889–1891

    Article  PubMed  Google Scholar 

  • DeMuink Keizer-Schrama SMPF, Hazebroek FWJ, Matroos AW, et al (1986) Double blind, placebo-controlled study of luteinising-hormone-releasing-hormone nasal spray in treatment of undescended testes. Lancet 1:876–880

    Article  PubMed  Google Scholar 

  • Donaldson KM, Tong SYC, Hutson JM (1996) Prevalence of late orchidopexy, despite recommendations for surgery in infancy, is consistent with some undescended testes being acquired. Indian J Pediatr 63:725–729

    PubMed  Google Scholar 

  • Emmen JM, McLusky A, Adham IM, Engel W, Grootegoed JA, Brinkmann AO (2000) Hormonal control of gubernaculum development during testis descent: gubernaculum outgrowth in vitro requires both insulin-like factor 3 and androgen. Endocrinology 144:4720–4727

    Article  Google Scholar 

  • Giwercman A, Bruin E, Frimodt-Moller C, Skakkebaek NE (1989) Prevalence of carcinoma-in-situ and other histopathological abnormalities in testes of men with a history of cryptorchidism. J Urol 142:998–1002

    PubMed  Google Scholar 

  • Goh DW, Hutson JM (1992) Is the retractile testis a normal, physiological variant or an anomaly that requires active treatment? Pediatr Surg Int 7:249–252

    Article  Google Scholar 

  • Hadziselimovic F (1986) Hormonal treatment of cryptorchidism. N Engl J Med 315–322

    Google Scholar 

  • Hadziselimovic F, Herzog B (2001) Importance of early postnatal germ cell maturation for fertility of cryptorchidism males. Horm Res 55:6–10

    Article  PubMed  Google Scholar 

  • Hadziselimovic F, Huff D (2002) Gonadal differentiation—normal and abnormal testicular descent. Adv Exp Med Biol 511:15–21

    PubMed  Google Scholar 

  • Heyns CF (1987) The gubernaculum during testicular descent in the human fetus. J Anat 153:93–112

    PubMed  Google Scholar 

  • Heyns CFG, Hutson JM (1995) The history of theories on testicular descent. J Urol 153:754–767

    Article  PubMed  Google Scholar 

  • Hrabovszky Z, Farmer PJ, Hutson JM (2000) Does the sensory nucleus of the genitofemoral nerve have a role in testicular descent? J Pediatr Surg 35:96–100

    PubMed  Google Scholar 

  • Huff DS, Hadziselimovic F, Mc Snyder HM III, et al (1989) Postnatal testicular maldevelopment in unilateral cryptorchidism. J Urol 142:546–548

    PubMed  Google Scholar 

  • Huff DA, Fenig DM, Canning DA, et al (2001a) Abnormal germ cell development in cryptorchidism. Horm Res 55:11–17

    Article  Google Scholar 

  • Huff DS, Snyder HM III, Rusnack SL, Zderic SA, Carr MC, Canning DA (2001b) Hormonal therapy for the subfertility of cryptorchidism. Horm Res 55:38–40

    Article  PubMed  Google Scholar 

  • Hunter J (1786) Observations on certain parts of the animal oeconomy. 13 Castle St, London, pp 1–26

    Google Scholar 

  • Hutson JM, Beasley SW (1992) The descent of the testis. Arnold, London, pp 1–187

    Google Scholar 

  • Hutson JM, Hasthorpe S (2005) Testicular descent and cryptorchidism:the state of the art in 2004. J Pediatr Surg 40:297-302

    PubMed  Google Scholar 

  • Hutson JM, Chow CW, Ng WD (1987) Persistent Müllerian duct syndrome with transverse testicular extopia: an experiment of nature with clues for understanding testicular descent. Pediatr Surg Int 2:191–194

    Google Scholar 

  • Hutson JM, Davidson PM, Reece LA, Baker ML, Zhou BY (1994) Failure of gubernacular development in the persistent Müllerian duct syndrome allows herniation of the testes. Pediatr Surg Int 9:544–546

    Google Scholar 

  • Hutson JM, Hasthorpe S, Heyns CF (1996) Anatomical and functional aspects of testicular descent and cryptorchidism. Endocr Rev 18:259–280

    Article  Google Scholar 

  • Huynh J, Farmer PJ, Yong EXZ, Sourial M, Donath S, Ting AYS, Hutson JM (2005) Calcitonin gene-related peptide stimulates mitosis in the tip of the rat gubernaculum in vitro. J Urol (in press)

  • Kolon TF, Patel RP, Huff DS (2004) Cryptorchidism: diagnosis, treatment, and long-term prognosis. Urol Clin N Am 31:469–480

    Article  Google Scholar 

  • Kubota Y, Temelcos C, Bathgate RAD, Smith KJ, Hutson JM (2002) The role of insulin 3, testosterone, MIS and relaxin in rat gubernacular growth. Hum Mol Reprod 8:900–905

    Article  Google Scholar 

  • Miesset R, Fonda PJ, Vaysse P, et al (1993) Increase in temperature in case of cryptorchidism in boys. Fertil Steril 59:1319–1321

    PubMed  Google Scholar 

  • Nef S, Parada LF (1999) Cryptorchidism in mice mutant for INSL3. Nat Genet 22:295–299

    Article  PubMed  Google Scholar 

  • Rajfer J, Handelsman DJ, Swerdloff RS, et al (1986) Hormonal therapy of cryptorchidism. A randomized, double-blind study comparing human chorionic gonadotrophin and gonadotrophin-releasing hormone. N Engl J Med 314:466–470

    PubMed  Google Scholar 

  • Ramasamy M, DiPilla N, Yap T, Hrabovszky Z, Farmer PJ, Hutson JM (2001) Enlargement of the processus vaginalis during testicular descent in rats. Pediatr Surg Int 17:312–315

    Article  PubMed  Google Scholar 

  • Sinclair AH (1995) New genes for boys. Am J Hum Genet 57:998–1001

    PubMed  Google Scholar 

  • Smith A, Hutson JM, Beasley SW, Reddihough DA (1989) The relationship between cerebral palsy and cryptorchidism. J Pediatr Surg 24:1303–1305

    PubMed  Google Scholar 

  • Tong SYC, Hutson JM, Watts LM (1996) Does testosterone diffuse down the Wolffian duct during sexual development? J Urol 155:2057–2059

    PubMed  Google Scholar 

  • Schoot P van der (1993) The cranial suspensory ligaments in mammalian anatomy should only be used to indicate the structures derived from the foetal cranial mesonephric and gonadal ligaments. Anat Rec 237:434–438

    Article  PubMed  Google Scholar 

  • Warne GL (1998) Advances and challenges with intersex disorders. Reprod Fertil Devel 10:79–85

    Article  Google Scholar 

  • Zhou B, Watts LM, Hutson JM (1993) Germ cell development in neonatal mouse testes in vitro Müllerian inhibiting substance. J Urol 150:613–616

    PubMed  Google Scholar 

  • Zhou BY, Hutson JM, Watts LM, et al (2002) Human chorionic gonadotrophin (hCG) stimulates spermatogenesis in immature mice in vivo. J Pediatr Surg 37:1751–1753

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Douglas Stephens Laboratory, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia

    John M. Hutson & Suzanne Hasthorpe

  2. Department of General Surgery, Royal Children’s Hospital, Parkville, Victoria, 3052, Australia

    John M. Hutson & Suzanne Hasthorpe

  3. Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia

    John M. Hutson & Suzanne Hasthorpe

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  1. John M. Hutson
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  2. Suzanne Hasthorpe
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Correspondence to John M. Hutson.

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Hutson, J.M., Hasthorpe, S. Abnormalities of testicular descent. Cell Tissue Res 322, 155–158 (2005). https://doi.org/10.1007/s00441-005-1126-4

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  • DOI: https://doi.org/10.1007/s00441-005-1126-4

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