The Role of the Appendix Testis in Normal Testicular Descent: Is There a Connection?

Zlatan Zvizdic,Emir Milisic,Jasmin Sabanovic,Dragana Zivkovic

doi:10.1155/2018/3078031

Abstract

Objective The presence of testicular appendices was prospectively evaluated in 89 boys with 96 undescended testes who underwent orchidopexy over the period of 4 years. Results The patients were divided into two groups. Group A included 42 boys with 49 undescended testes positioned close to the internal inguinal ring, and Group B included 47 boys with 47 undescended testes close to the external inguinal ring. The incidence of appendix testis (AT) in Group A was 57.1% (28 in 49) and 78.7% (37 in 47) in Group B. The results of our study showed significantly decreased incidence of testicular appendices in undescended testes positioned close to the internal inguinal ring compared with undescended testes positioned close to the external inguinal ring (p < 0.05). Conclusion AT may play a role in normal testicular descent and the undescended testis positioned close to the external inguinal ring can be considered as a separate entity of the true congenital undescended testis.

Highlights

Normal testicular descent (TD) is a complex, multistage process that involves coordinated action of various anatomical structures, hormones, environment, and genetic factors [1]
The majority of patients with undescended testes (UDTs) who underwent orchidopexy were below the age of 1 year (51.7%) (χ2(3) = 16.80, p = 0.0008)
Right localization was more represented in the group with testis retention (53.2%) than in the group with cryptorchidism (42.9%), while left and two-sided localization was slightly more represented in the group of patients with cryptorchidism, but without statistically significant difference (p > 0.05)

Summary

Introduction

Normal testicular descent (TD) is a complex, multistage process that involves coordinated action of various anatomical structures, hormones, environment, and genetic factors [1]. The results of experimental studies have confirmed that the synergistic action of testicular INSL3 and androgens contribute to gubernacular development and testicular descent [4, 5]. Many aspects of impairment of testicular descent are still unclear. In an attempt to clarify these uncertainties, recent studies have hypothesized about the possible role of the appendix testis (AT) in testicular descent noticing a reduced incidence of AT among boys with undescended testes (UDTs) compared to boys without testicular maldescent [6, 7]. According to the best of the author’s knowledge, there is no report of the conducted studies that have compared the incidence of AT in congenital UDTs at different localizations

Methods

Results

Conclusion