Testicular descent, cryptorchidism and inguinal hernia: the Melbourne perspective

Tomiyama, Hideki; Sasaki, Yasunari; Huynh, Jenny; Yong, Eric; Ting, Alvin; Hutson, John M.

doi:10.1016/j.jpurol.2004.11.001

« Previous Next »Journal of Pediatric Urology
Volume 1, Issue 1 , Pages 11-25, February 2005

Testicular descent, cryptorchidism and inguinal hernia: the Melbourne perspective

Hideki Tomiyama
- F. Douglas Stephens Surgical Research Laboratory, Murdoch Children's Research Institute, Australia
- Department of General Surgery, Royal Children's Hospital, Victoria, Australia
Yasunari Sasaki
- F. Douglas Stephens Surgical Research Laboratory, Murdoch Children's Research Institute, Australia
- Department of General Surgery, Royal Children's Hospital, Victoria, Australia
Jenny Huynh
- F. Douglas Stephens Surgical Research Laboratory, Murdoch Children's Research Institute, Australia
- Department of General Surgery, Royal Children's Hospital, Victoria, Australia
Eric Yong
- F. Douglas Stephens Surgical Research Laboratory, Murdoch Children's Research Institute, Australia
- Department of General Surgery, Royal Children's Hospital, Victoria, Australia
Alvin Ting
- F. Douglas Stephens Surgical Research Laboratory, Murdoch Children's Research Institute, Australia
- Department of General Surgery, Royal Children's Hospital, Victoria, Australia
John M. Hutson
- F. Douglas Stephens Surgical Research Laboratory, Murdoch Children's Research Institute, Australia
- Department of General Surgery, Royal Children's Hospital, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Corresponding author. Department of General Surgery, Royal Children's Hospital, Parkville, Victoria 3052, Australia. Tel.: +61 3 9345 5805; fax: +61 3 9345 7997.

Received 7 September 2004

Abstract

Cryptorchidism is the commonest congenital genitourinary anomaly in males and results when the testis does not descend into its normal intrascrotal position during development. In full-term infants, the incidence is ≈3% at birth. Cryptorchidism results in several abnormalities, including attenuated spermatogenesis, infertility and a greater risk of malignancy. The normal mechanism of testicular descent appears to be multi-staged, with various anatomical factors and hormonal influences, but the exact process is still unclear. In this article we review the current theories of normal testicular descent, with a focus on the hormones and anatomical factors, and current treatments for undescended testis.

Keywords: Testicular descent, Cryptorchidism, Inguinal hernia, Gubernaculum

Abbreviations: UDT, undescended testis, MIS, Müllerian-inhibiting substance, AMH, anti-Müllerian hormone, INSL3, insulin-like hormone 3, CSL, cranial suspensory ligament, PV, processus vaginalis, CM, cremaster muscle, GFN, genitofemoral nerve, CGRP, calcitonin gene-related peptide, PMDS, persistent Müllerian duct syndrome