ARTICLE INFO ______________________________________________________________ ______________________Objectives: The objective of this review is to study the role of the gubernaculum in the testicular migration process during the human fetal period. Materials and Methods:We performed a descriptive review of the literature about the role of the gubernaculum in testicular migration during the human fetal period.Results: In the first phase of testicular migration, the gubernaculum enlarges to hold the testis near the groin and in the second phase the gubernaculum migrates across the pubic region to reach the scrotum. The proximal portion of the gubernaculum is attached to the testis and epididymis and the presence of multiple insertions in the distal gubernaculum is extremely rare. The presence of muscle and nerves in the human gubernaculum is very poor. The gubernaculum of patients with cryptorchidism has more fibrous tissue and less collagen and when the patients are submitted to hormonal treatment, the gubernaculum components alter significantly. Conclusions:The gubernaculum presents significant structural modifications during testicular migration in human fetuses.
Objectives To assess the incidence of testicular appendices (Tas), epididymal anomalies (EAs), and processus vaginalis (PV) patency in patients with undescended testis (UT) according to testicular position and to compare them with human fetuses. Methods We studied 85 patients (108 testes) with cryptorchidism and compared the features with those of 15 fetuses (30 testes) with scrotal testes. We analyzed the relationships among the testis and epididymis, patency of PV, and the presence of TAs. We used the Chi-square test for statistical analysis (p < 0.05). Results In 108 UT, 72 (66.66%) had PV patent, 67 (62.03%) had TAs, and 39 (36.12%) had EAs. Of the 108 UT, 14 were abdominal (12.96%; 14 had PV patency, 9 TAs, and 7 EAs); 81 were inguinal (75%; 52 had PV patency, 45 TAs, and 31 EAs), and 13 were suprascrotal (12.03%; 6 had PV patency, 13 TAs, and 1 EAs). The patency of PV was more frequently associated with EAs (p = 0.00364). The EAs had a higher prevalence in UT compared with fetuses (p = 0.0005). Conclusions Undescended testis has a higher risk of anatomical anomalies and the testes situated in abdomen and inguinal canal have a higher risk of presenting patency of PV and EAs.
Background: The objective of this study is to analyze the incidence of congenital urogenital malformations in human fetuses with neural tube defects (NTDs). Methods: We studied 320 human fetuses (214 males and 106 female) ranged in age from 12 to 35 weeks post-conception (WPC). The fetuses were carefully dissected with the aid of a stereoscopic lens with 16/25× magnification. The abdomen and pelvis were opened to identify and expose the urogenital organs. We studied the incidence of renal, ureteral, bladder, urethral, testicular, epididymal, vas deferens, prostate and penile and uterine anomalies. The renal anomalies were divided into rotation, fusion, number and ascension. We observed the presence of seminalvesicle and ureteral duplication, bladderseptation, hypospadias and posterior urethral valve. Results: We observed 17 fetuses (5.31%) with NTDs ranged in age between 18 to 34 WPC, weighted between 170 and 2325 g, and had crownrump length between 13 and 34 cm. Of the 17 fetuses, 4 (23.4%) presented some kind of anomaly of the urogenital system. Renal anomalies were found in three fetuses (17.6%) and a duplication of the left ureter in one fetus (5.8%). We do not observe anomalies in genital organs in this sample. Conclusions: We concluded that the urogenital anomalies in human fetuses with neural tube defects are significant with an incidence superior a 20%. In this study we have not found severe urogenital anomaly that causes damage of the body function.
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