Abstract
Purpose
In order to evaluate the gubernaculum (GN) abnormalities quantitatively in patients with undescended testes (UDT), the area and attachment site of the gubernaculum were evaluated.
Patients and methods
Sixty-seven testes from 61 patients with an undescended testis treated in the past 11 years at our institution were examined. Using intraoperative photographs or DVDs, the area of the GN inside the processus vaginalis was measured, and the ratio to that of the testis was determined. When the GN was attached to the vas deferens, the GN distance from the testis was also measured, and the ratio to that of the transverse length of the testis (deviation index) was calculated. Reference values were obtained from 23 testes from 15 patients with mobile testes.
Results
In cases with mobile testes, the GN attached to the bottom of the testis, and involved the lower pole of the epididymis. Even though the GN was attached to the bottom of the testis in 43 testes in the UDT patients (64 %), the GN was found to be elongated. The mean GN area ratio was 1.58 (1SD, 0.6) in the UDT cases, in comparison to 0.47 (0.2) in the cases with mobile testes. The GN was attached to the vas deferens in 24 testes (36 %). The deviation index was 1.34 (1.0), but the GN area ratio of these cases was 1.56 (0.7), which was similar to that of the GN attached to the bottom of the testis.
Conclusion
The present study revealed that an increase in the GN area ratio was the most common imaging abnormality in cases with UDT.
Similar content being viewed by others
References
Hutson JM (1985) A biphasic model for the hormonal control of testicular descent. Lancet 2:419–421
Barteczko KJ, Jacob MI (2000) The testicular descent in human. Origin, development and fate of the gubernaculum Hunteri, processus vaginalis peritonei, and gonadal ligaments. Adv Anat Embryol Cell Biol 156:1–98
Niikura H, Okamoto S, Nagase S et al (2008) Fetal development of the human gubernaculum with special reference to the fasciae and muscles around it. Clin Anat 21:547–557
Abe T, Aoyama K, Gotoh T et al (1996) Cranial attachment of the gubernaculum associated with undescended testes. J Pediatr Surg 31:652–655
Kubota M, Okuyama N, Yamazaki S et al (2007) Is mobile testis a true pathological condition due to a gubernaculum abnormality? Pediatr Surg Int 23:633–636
Scorer CG (1962) The anatomy of testicular descent–normal and incomplete. Br J Surg 49:357–367
Heyns CF (1987) The gubernaculum during testicular descent in the human fetus. J Anat 153:93–112
El Zoghbi CS, Favorito LA, Costa WS et al (2007) Structural analysis of gubernaculum testis in cryptorchid patients submitted to treatment with human chorionic gonadotrophin. Int Braz J Urol 33:223–229 (discussion 230)
Vigueras RM, Moreno-Mendoza N, Reyes G et al (2003) Androgen receptor and calcitonin gene-related peptide in neurons of the genitofemoral nerve during testicular descent induced with human chorionic gonadotropin. Arch Med Res 34:166–170
Spencer JR, Vaughan ED Jr, Imperato-McGinley J (1993) Studies of the hormonal control of postnatal testicular descent in the rat. J Urol 149:618–623
Hutson JM (1986) Testicular feminization: a model for testicular descent in mice and men. J Pediatr Surg 21:195–198
Favorito LA, Klojda CA, Costa WS et al (2003) Is there a relationship with anomalous insertions of the distal gubernaculum testis and testicular ectopia? Analysis in human fetuses and patients with cryptorchidism. J Urol 170:554–557
Acknowledgments
The authors would like to thank Mr. Brian Quinn for his critical reading of this manuscript. Grant Support: Grant-in-aid for Exploratory Research (No. 24659773) from the Japan Society for the Promotion of Science.
Conflict of interest
The authors state that they have no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kubota, M., Nakaya, K., Arai, Y. et al. The area and attachment abnormalities of the gubernaculum in patients with undescended testes in comparison with those with retractile testes. Pediatr Surg Int 30, 1149–1154 (2014). https://doi.org/10.1007/s00383-014-3597-4
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-014-3597-4