Study of Testicular Structure in Fetuses with Prune Belly Syndrome

Abstract

Purpose To compare the structure of the testis in fetuses with prune belly syndrome (PBS) to normal controls. Materials and Methods We studied 6 testes obtained from 3 fetuses with PBS and 14 testes from 7 male fetuses. The testicular specimens were cut into 5-μm thick sections and stained with hematoxylin and eosin (HE), to observe the seminiferous tubules; Weigert's solution to observe elastic fibers; and picrosirius red to observe collagen. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done with the Image Pro and Image J programs. Means were statistically compared using the Mann–Whitney U test (p < 0.005). Results Quantitative analysis documented no differences (p = 0.4) in number of seminiferous tubules (ST) in PBS testes (mean = 8.87%, SD = 1.59), when compared to the control (mean = 11.4%, SD = 2.99) and no differences (p = 0.8) in diameter of ST in PBS testes (mean = 52.85 μm, SD = 1.58) when compared to the control group (mean = 53.17 μm, SD = 1.55), but we did observe a lower number (p = 0.0002) of Leydig cells in the PBS testes (mean = 67.03% and SD = 3.697) when compared to the control group (mean = 90.1% and SD = 2.986). Conclusions Our study showed a lower concentration of Leydig cells in the triad syndrome fetuses.

<p>Prune belly syndrome: current perspectives</p>

“…It should be emphasized, however, that in the absence of any overriding cardiopulmonary issue, orchidopexy should be performed as recommended by the current AUA guideline and not delayed until older in childhood 52,53. Rather, since germinative epithelium is significantly reduced in males with PBS, orchidopexy should be performed as early as possible to enhance the chances of fertility 54–57. Division of the gonadal vessels is less likely when orchidopexy is performed early.…”

Prune-belly syndrome in Africa: An analysis and systematic review of cases, etiology, treatment, and outcomes

“…Whereas the abdominal muscle deficiency and urinary tract anomalies may occur from a mesodermal defect, cryptorchidism is thought to result from impaired abdominal muscle contraction, distension of the bladder that inhibits the testes’ descent, and inguinal canal structural changes or the gubernaculum testis’ alteration. 49–51 Thus, all PBS patients are infertile. 16 PBS usually is a sporadic condition; however, familial cases have been documented, suggesting a possible genetic cause.…”