Late ascended testes: is non-orthotopic gubernacular insertion a confirmation of an alternative embryological etiology?

Haid, Bernhard; Sılay, Mesrur Selçuk; Radford, Anna; Rein, Patrick; Bañuelos, B Abad; Oswald, Josef; Spinoit, Anne‐Françoise

doi:10.1016/j.jpurol.2018.10.013

Cited by 11 publications

(10 citation statements)

References 23 publications

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“…In these cases, the cremasteric reflex, influenced by neurological impairment, could be responsible for late ascension of gonads, but gubernacular abnormal insertion has been suggested as a cause too. 5,14 In our case series, traditional risk factors 10 do not seem to explain the presence of cryptorchidism. We observed just two cases of low birth weight and one case of prematurity.…”

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confidence: 54%

Cryptorchidism in Children with Zika-Related Microcephaly

Vasconcelos

Ximenes

Calado

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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The genitourinary tract was recently identified as a potential site of complications related to the congenital Zika syndrome (CZS). We provide the first report of a series of cryptorchidism cases in 3-year-old children with Zikarelated microcephaly who underwent consultations between October 2018 and April 2019 as part of the follow-up of the children cohort of the Microcephaly Epidemic Research Group, Pernambuco, Brazil. Of the 22 males examined, eight (36.4%) presented with cryptorchidism. Among 14 undescended testis cases, 11 (78.6%) could be palpated in the inguinal region. Seven of the eight children had severe microcephaly. Conventional risk factors for cryptorchidism were relatively infrequent in these children. We hypothesize that cryptorchidism is an additional manifestation of CZS present in children with severe microcephaly. As in our cases, for most of the children, the testes were located in the inguinal region, and the possible mechanisms for cryptorchidism were gubernaculum disturbance or cremasteric abnormality.

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confidence: 54%

Cryptorchidism in Children with Zika-Related Microcephaly

Vasconcelos

Ximenes

Calado

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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“…An incomplete disappearance of processus vaginalis can result in a fibrous remnant within the spermatic cord that cannot elongate with age has been a suggested cause for the ascending testis [92,127]. Also, an abnormal gubernaculum insertion site or an endocrine deficiency have been suggested as etiological factors, especially for ascending testis [128][129][130]. A recent study claim that the etiology of ascending testes involves similar operative findings as to the congenital condition, suggesting that ascending testis is a congenital condition and is first noticeable with the child's growth [131].…”

Section: Etiology and Risk Factorsmentioning

confidence: 99%

Clinical aspects of histological and hormonal parameters in boys with cryptorchidism

Hildorf

2022

APMIS

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“…3) Reascended testis, which a previously descended testis ascends to a higher position, comprises some proportion of cases of undescended testis. An abnormally persistent fibrotic remnant of the processus vaginalis, 17) patent processus vaginalis, and nonorthotopic gubernacular insertion (higher insertion) 18) are suggested causes of reascended testis.…”

Section: Risk Factorsmentioning

confidence: 99%

Comparison of diagnostic and treatment guidelines for undescended testis

Shin

Jeon

2020

Clin Exp Pediatr

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Cryptorchidism or undescended testis is the single most com mon genitourinary disease in male neonates. In most cases, the testes will descend spontaneously by 3 months of age. If the testes do not descend by 6 months of age, the probability of spontaneous descent thereafter is low. About 1%-2% of boys older than 6 months have undescended testes after their early postnatal descent. In some cases, a testis vanishes in the abdomen or reascends after birth which was present in the scrotum at birth. An inguinal undescended testis is sometimes mistaken for an inguinal hernia. A surgical specialist referral is recommended if descent does not occur by 6 months, unde scended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. International guidelines do not recommend ultrasonography or other diagnostic imaging because they cannot add diagnostic accuracy or change treat ment. Routine hormonal therapy is not recommended for undescended testis due to a lack of evidence. Orchiopexy is recommended between 6 and 18 months at the latest to pro tect the fertility potential and decrease the risk of malignant changes. Patients with unilateral undescended testis have an infertility rate of up to 10%. This rate is even higher in patients with bilateral undescended testes, with intraabdominal un de scended testis, or who underwent delayed orchiopexy. Pa tients with undescended testis have a threefold increased risk of testicular cancer later in life compared to the general pop ulation. Selfexamination after puberty is recommended to facilitate early cancer detection. A timely referral to a surgical specialist and timely surgical correction are the most important factors for decreasing infertility and testicular cancer rates.

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Late ascended testes: is non-orthotopic gubernacular insertion a confirmation of an alternative embryological etiology?

Cited by 11 publications

References 23 publications

Cryptorchidism in Children with Zika-Related Microcephaly

Cryptorchidism in Children with Zika-Related Microcephaly

Clinical aspects of histological and hormonal parameters in boys with cryptorchidism

Comparison of diagnostic and treatment guidelines for undescended testis

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