By Prof. Dr. John M. Hutson, Dr. Masaru Terada, Dr. Baiyun Zhou, Dr. Martyn P. L. Williams (auth.)
This evaluation describes contemporary examine into the reason for testicular descent and discusses debatable theories at the mechanism. New animal versions of cryptorchidism are defined which make clear the prospective aetiology. a short precis is given of present administration, highlighting the controversies of timing of surgical procedure, use of hormone remedy and congenital as opposed to "acquired" undescended testes. New information regarding germ telephone improvement within the postnatal testis is altering the best way we view remedy and the last word prognosis.
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Extra info for Normal Testicular Descent and the Aetiology of Cryptorchidism
To test this possibility, two groups of males with cerebral palsy were compared with age-matched controls, most of whom had asthma. The distance from the pubic tubercle to the middle of the testis under mild traction, representing the length of the spermatic Table 4. Possible causes of congenital vs acquired cryptorchidism Anomaly Possible cause Congenital cryptorchidism Acquired cryptorchidism Failure of first/second phase of testicular descent Failure of elongation of spermatic cord Cerebral palsy (cremaster spacticity) Persisting remnant of processus vaginalis A 8 Fig.
J Anat 77: 179-188 Yamanaka J, Baker M, Metcalfe S, Hutson JM (1991) Serum levels of mtillerian inhibiting substance in boys with cryptorchidism. J Pediatr Surg 26: 621-623 Yamanaka J, Metcalfe SA, Hutson JM (1992) Demonstration of calcitonin gene-related peptide receptors in the gubernaculum by computerized densitometry. J Pediatr Surg 27: 876-878 Yamanaka J, Metcalfe SA, Hutson JM, Mendelsohn FAO (1993) Testicular descent II. Ontogeny and response to denvervation of calcitonin gene-related peptide receptors in neonatal rat gubernaculum.
Central to the argument is the genetic mutation causing persisting mtillerian duct syndrome, which clearly implicates MIS in gubernacular development. Reassessment of the way testosterone is involved in the second step of descent led to the idea that androgens may direct gubernacular migration via release of a second messenger from the GFN. CGRP has been found not only to have a pivotal role in normal testicular descent in rodents, but also in cryptorchid rodents, suggesting that it may be an important factor in many species.
Normal Testicular Descent and the Aetiology of Cryptorchidism by Prof. Dr. John M. Hutson, Dr. Masaru Terada, Dr. Baiyun Zhou, Dr. Martyn P. L. Williams (auth.)