Bilateral Abdominal Cryptorchidism Research Articles

Single-port laparoscopic-assisted abdominal cryptorchidectomy in 14 dogs.

To describe a modified laparoscopic-assisted cryptorchidectomy technique in dogs using a single-port endoscope and evaluate clinical outcome in abdominal cryptorchid dogs that underwent the procedure. Prospective case series. A total of 14 client-owned dogs (19 abdominal cryptorchid testes). Dogs scheduled for laparoscopic cryptorchidectomy between January 2019 and April 2022 were enrolled in the study. The dogs underwent single-port laparoscopic-assisted cryptorchidectomy (SP-LAC) performed by a single surgeon using a 10-mm single-port endoscope placed in the midline immediately cranial to the prepuce. The abdominal testis was endoscopically located and grasped, the cannula was retracted, the capnoperitoneum was reversed to allow exteriorization of the testis, and the spermatic cord was ligated extracorporeally. Median age was 13 months (range, 7-29 months) and median bodyweight was 23.0 kg (range, 2.2-55.0 kg). Nine of 14 dogs had unilateral abdominal cryptorchidism (7 right-sided and 2 left-sided) and 5/14 dogs had bilateral abdominal cryptorchidism. Median surgical time for unilateral abdominal cryptorchidectomy was 17 min (range, 14-21 min) and for bilateral abdominal cryptorchidectomy 27 min (range, 23-55 min). Ten dogs had additional surgical procedures performed concurrently with SP-LAC. One major intraoperative complication (testicular artery hemorrhage) occurred that required emergency conversion and two minor entry-related complications were observed. The SP-LAC procedure enabled removal of abdominal testes and was associated with a low morbidity. The SP-LAC procedure can be performed by a single surgeon and represents a less invasive alternative to multi-port laparoscopic-assisted or single-port multi-access laparoscopic cryptorchidectomy techniques.

Anti-Müllerian hormone levels in serum and testes of male dogs: relations with neuter status and bilateral abdominal cryptorchidism

Anti-Müllerian hormone (AMH) analysis has contributed to new information in the reproductive endocrinology of domestic animals, due to clinically available diagnostic tools. An accurate and rapid diagnostic method to distinguish between neutered and bilateral abdominal cryptorchid dogs is needed in veterinary practice. Therefore, this study uses an enzyme-linked immunosorbent assay to evaluate the clinical relevance of AMH analysis in peripheral blood as a diagnostic tool for dogs with suspected bilateral abdominal cryptorchidism. The possible alteration of the AMH localization in testicular tissue caused by this pathologic condition was also investigated using immunohistochemistry. Male dogs were divided into three groups of healthy intact (n = 14), healthy castrated (n = 14), and bilateral abdominal cryptorchid (n = 14) dogs. The results demonstrated a higher level of serum AMH in the cryptorchid group compared to the intact group (P < 0.01), while serum AMH levels of all castrated dogs were below the limit of detection (<0.05 ng/mL). Moreover, the percentage of positive AMH immunostaining of the intact group was less than that of the cryptorchid group (P < 0.01). A significantly positive correlation was found between serum AMH concentration and localization in testicular tissues (r = 0.93, P < 0.01). Our findings suggest that AMH levels in the peripheral blood could be used as an alternative and rapid screening method for detecting dogs with abdominal cryptorchidism.

BILATERAL CRYPTORCHIDISM IN PEDIATRIC SURGEON'S PRACTICE: CURRENT TACTICS OF PATIENT MANAGEMENT.

The aim: To provide best practices of disease management to improve treatment outcomes for this group of patients. Materials and methods: The paper is based on first-hand experience in observing and treating 117 children aged from 6 months to 13 years with bilateral congenital cryptorchidism during a ten-year follow-up period, who were referred for surgical treatment, and 3 newborn boys with undescended testicles and testicular torsion. A complex of clinical and laboratory, instrumental, endocrinological, and genetic research methods was used for the survey of all patients. Results: Recognizing the action of a common causative factor for bilateral cryptorchidism, which is a consequence of primary endocrine disorders, makes it possible to predict bilateral identity of the location of testicles in this pathology, which we observed in 81 patients: bilateral inguinal cryptorchidism was registered in 49 (41.88%) children, bilateral abdominal cryptorchidism - in 32 (27.35%) children, a combination of inguinal and abdominal cryptorchidism - in 24 (20.51%) children. The following types of treatment were used in the studied group of children: 1 - primary surgical intervention - 4 children, representing 3.42%. 2 - observation and non-surgical treatment by an endocrinologist - 113 (96.58%) children. 3 - comprehensive treatment (surgical correction after hormone treatment) - 67 (59.29%) children. According to the research, hormone therapy had a positive effect on descent of the testicles in 89 (78.76%) patients: the testicles descended into the scrotum - in 22 (24.72%) children; the testicles descended in the inguinal canal - in 32 (35.95%) children; the testicles descended to the level of the opening to the inguinal canal - in 35 (39.33%) children. Conclusions: 1. All doctors, starting from the maternity hospital, polyclinic, children's unit, should identify children with bilateral cryptorchidism. All children diagnosed with bilateral cryptorchidism are referred to a surgeon or endocrinologist. The parents of a child with bilateral cryptorchidism should immediately consult a doctor. The study of the reasons for late admission of children to the surgical hospital revealed that 76.92% of patients sought medical advice late, after 1 year of life. 2. At the stage of diagnosis and determination of treatment tactics, an examination by an endocrinologist and a geneticist is necessary; ignoring them is considered an error in diagnostic and therapeutic tactics, since the process of descent of the testicles into the scrotum is hormone-dependent. 3. The indications for primary surgical treatment of a child with bilateral cryptorchidism involve a combination of cryptorchidism with inguinal hernia and pain syndrome, which might be caused by testicular torsion. 4. Hormone therapy provides better results of surgical intervention in bilateral cryptorchidism. The ineffectiveness of two courses of hormone therapy necessitates surgical treatment. 5. Comprehensive treatment of children with bilateral cryptorchidism (non-surgical hormone therapy and surgical correction) has led to good postoperative results in 71.64% of patients, satisfactory results - in 22.39% of children, recurrences - in 5.97% of patients. 7. A long-term follow-up observation should be carried out by a surgeon and endocrinologist until patients reach their reproductive years.

Нарушение формирования пола 46 XY и двусторонняя метахронная опухоль Вильмса у ребенка с мутацией в экзоне 7 гена WT1

Denys-Drash syndrome is characterized by a triad: nephropathy, a 46, XY disorder of sex development, and nephroblastoma with mutations in the gene WT1. A clinical case of a patient with a bilateral metachronous Wilms' tumor, a 46, XY disorder of sex development in the form of a scrotal hypospadias and bilateral abdominal cryptorchidism, without nephropathy with a mutation in 7 exon of gene WT1 is presented in the article. The child underwent left-sided nephrectomy, lower pole right partial nephrectomy, bilateral orchiopexy and two-stage correction of hypospadias. After 7 years from the start of treatment and 3 years after the last procedure, the childs condition has been assessed as satisfactory. The presented case, according to the analysis of literature, has not been previously described, therefore, it currently remains as "de novo" and requires further observation.

&lt;i&gt;WT1&lt;/i&gt; gene mutation in exone 7 in boy with disturbance of the sex formation and the bilateral nephroblastoma

The case of observing a patient with WT1 gene mutation in exone 7 with bilateral Wilms metachronous tumor, disturbance of the sex formation in the form of scrotal hypospadias and bilateral abdominal cryptorchidism, without nephropathy, is presented. The child underwent surgical operations: left-sided nephrectomy, resection of the lower pole of the right kidney, bilateral orchiopexy and two-stage hypospadias correction. 7 years after the start of treatment and 3 years after the final operation, the condition of the child was estimated as satisfactory. The presented case by the results of the molecular genetic study has no previously described analogues and requires further observation.

Application of rat cryptorchidism model for the evaluation of mesenchymal stromal cell secretome regenerative potential

Male infertility represents a severe social and medical challenge. In recent years the progress in regenerative medicine promoted the development of novel options to overcome this medical condition. We are elaborating a promising approach to restore spermatogenesis using mesenchymal stromal cell (MSC) secretome components as a novel class of cell-free cell therapy medicinal products for regenerative medicine. However, the choice of the representative in vivo model of spermatogenesis failure to evaluate the effectiveness of regenerative drugs remains challenging. Using the rat model of bilateral abdominal cryptorchidism, we studied the contribution of MSC conditioned medium contained bioactive cell secreted products to the spermatogenesis recovery. The feasibility of this model to evaluate the drug-driven regenerative effects on spermatogenesis restoration after the injury was demonstrated. We revealed significant correlations between the extent of spermatogonial stem cell niche recovery, spermatozoa count and serum concentration of androgens as an indicator of Leydig cell function. The obtained results can be applied in preclinical studies to choose the proper criteria to appraise the specific activity of novel regenerative drugs developed for the treatment of non-obstructive spermatogenesis disorders.

Crossed-Fused Testicular Ectopia: A Case for the Use of Laparoscopy to Evaluate Nonpalpable Testicles

A 1-year-old male was referred for evaluation of a nonpalpable right testicle. In children with nonpalpable testicles, it our practice to proceed with diagnostic laparoscopy in an attempt to identify an intra-abdominal testicle or blind-ending spermatic vessels regardless of ultrasound findings. In the operating room, we performed diagnostic laparoscopy through the umbilical stump. We identified a vas deferens passing from the right side to the left side, and what appeared to be a testicle in the area of the left internal inguinal ring (Figures 1 and 2). In the left groin, we found both testicles fused together with a common blood supply, but a separate vas deferens. We placed the right testicle transseptally into the right hemiscrotum.Figure 2Right testicle entering the left inguinal ring.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Crossed testicular ectopia, or transverse testicular ectopia, is an extremely rare finding on exploration for an undescended testicle, with just slightly more than 100 cases reported in the literature to date.1Lam W.W. Le S.D. Chan K.L. Chan F.L. Tam P.K. Transverse testicular ectopia detected by MR imaging and MR venography.Pediatr Radiol. 2002; 32: 126-129Crossref PubMed Scopus (45) Google Scholar, 2Malik M.A. Iqbal Z. Chaudri K.M. Malik N.A. Ahmed A.J. Crossed testicular ectopia.Urology. 2008; 71 (984 e5-6)Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar A classification system has been proposed that accounts for accompanying anomalies, including hernias and mullerian duct structures.3Gauderer M.W. Grisoni E.R. Stellato T.A. Ponsky J.L. Izant Jr., R.J. Transverse testicular ectopia.J Pediatr Surg. 1982; 17: 43-47Abstract Full Text PDF PubMed Scopus (88) Google Scholar The ectopic testicle is usually structurally normal; however, it does carry a risk of malignancy, similar to that associated with other forms of intra-abdominal testicles.4Berkmen F. Persistent mullerian duct syndrome with or without transverse testicular ectopia and testis tumours.Br J Urol. 1997; 79: 122-126Crossref PubMed Google Scholar, 5Naouar S. Maazoun K. Sahnoun L. Jouini R. Ksia A. Elezzi O. et al.Transverse testicular ectopia: a three-case report and review of the literature.Urology. 2008; 71: 1070-1073Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar Although there are reports of successful diagnosis of this anomaly using ultrasonography6Pinto C.W. Toro R.C. Mansilla K.H. Castro T.A. Fuente-Alba C.S. Crossed testicular ectopia.J Ultrasound Med. 2010; 29: 847-849PubMed Google Scholar or magnetic resonance imaging1Lam W.W. Le S.D. Chan K.L. Chan F.L. Tam P.K. Transverse testicular ectopia detected by MR imaging and MR venography.Pediatr Radiol. 2002; 32: 126-129Crossref PubMed Scopus (45) Google Scholar during evaluation of nonpalpable testicles, neither of these studies is sufficiently sensitive to safely rule out an ectopic testicle.7Gokce M.I. Burgu B. Aydogdu O. Fitoz S. Soygur T. Transverse testicular ectopia associated with persistent Mullerian duct syndrome: another entity in which magnetic resonance imaging is unreliable.Urology. 2010; 76: 1475-1477Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar, 8Tasian G.E. Copp H.L. Diagnostic performance of ultrasound in nonpalpable cryptorchidism: a systematic review and meta-analysis.Pediatrics. 2011; 127: 119-128Crossref PubMed Scopus (93) Google Scholar Laparoscopy has consistently demonstrated superior diagnostic accuracy in nonpalpable testicles9Papparella A. Romano M. Noviello C. Cobellis G. Nino F. Del Monaco C. et al.The value of laparoscopy in the management of non-palpable testis.J Pediatr Urol. 2010; 6: 550-554Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar, 10Cortesi N. Ferrari P. Zambarda E. Manenti A. Baldini A. Morano F.P. Diagnosis of bilateral abdominal cryptorchidism by laparoscopy.Endoscopy. 1976; 8: 33-34Crossref PubMed Scopus (278) Google Scholar, 11Jordan G.H. Winslow B.H. Laparoscopic single-stage and staged orchiopexy.J Urol. 1994; 152: 1249-1252PubMed Google Scholar, 12Siemer S. Humke U. Uder M. Hildebrandt U. Karadiakos N. Ziegler M. Diagnosis of nonpalpable testes in childhood: comparison of magnetic resonance imaging and laparoscopy in a prospective study.Eur J Pediatr Surg. 2000; 10: 114-118Crossref PubMed Scopus (33) Google Scholar and is instrumental in their evaluation and treatment as underscored by this unusual finding on exploration.

Bilateral abdominal cryptorchidism with large left testicular seminoma and failed right urogenital union

This is a case report of a 32-year-old male with bilateral intra-abdominal cryptorchidism. A large seminoma had developed on the left testis with paraaortic lymph nodes metastasis. The tumour was excised easily. The right testis was found just inside the deep inguinal ring, without the vas deferens in the spermatic cord. The patient requested orchidopexy despite the well-explained risk of cancer development. Therefore, a second right groin incision was performed. In the right inguinal canal, there was a normal-looking vas deferens that ended in an atrophic nubbin of fibrous tissue without an epididymis. This is the sixth case in the literature of failed urogenital union resulting in complete separation of testis and vas deferens. The patient underwent orchidopexy and had four cycles of chemotherapy, which led to complete remission of the metastasis. This case highlights the fact that an impalpable undescended testis and finding of blind-end vas deferentia are not enough to establish the diagnosis of vanished testis. The decision to undergo orchiectomy in cases of bilateral cryptorchidism after puberty is also discussed. In our opinion, the choice should be made by the patient after a discussion of the risk for cancer development in the salvaged testis.

Proliferation and apoptosis of spermatogonia in postpuberal boar ( Sus domesticus) testes with spontaneous unilateral and bilateral abdominal cryptorchidism

Cryptorchidism is a frequent male sexual disorder in mammals, which affects the histology of the tunica propria, interstitial tissue, blood vessels, seminiferous epithelium and testis functioning. In this paper, proliferation and apoptosis were examined in the seminiferous epithelium of both testes from unaffected boars and from boars suffering unilateral and bilateral cryptorchidism. In germ cells, proliferation was studied using the immunohistochemical PCNA technique, and apoptosis was analysed by in situ TUNEL labelling. An index was obtained for the proliferation and apoptosis observed in seminiferous tubules. In abdominal testes the epithelium contained few spermatogonia and Sertoli cells. In the testes of unaffected boars, numerous spermatogonia proliferated, whereas in cryptorchid testes such proliferation was lower and the proliferation/apoptosis ratio diminished. In the unaffected group, the TUNEL-positive germ cells were spermatogonia and spermatocytes in different phases of meiosis. In abdominal testes, the TUNEL-positive germ cells were spermatogonia alone. The apoptosis index of both abdominal and scrotal testes was similar. In conclusion, spontaneous cryptorchid testes showed a lower rate of spermatogonia proliferation in the seminiferous epithelium.

Histochemical Study of the Interstitial Tissue in Scrotal and Abdominal Boar Testes

The present study describes the glycosidic content of the interstitial tissue in testes from healthy boars and from unilateral and bilateral abdominal cryptorchid boars using lectin histochemistry. The Leydig cells of healthy boars contained glycans with fucosyl, mannosyl, glucosyl, neuraminic acid and galactosyl residues, which have structural and transport functions, and participate in androgen synthesis and in cell regulation. Unilateral cryptorchidism induced high glucosyl and low galactosyl content in the Leydig cells of scrotal testes, resulting in impaired androgen production. In abdominal testes, the Leydig cells exhibited increased amounts of glucosyl and reduced amounts of galactosyl and neuraminic acid residues, resulting in defective cell regulation and lack of androgen synthesis. In healthy boars, the extracellular glycans contained fucosyl, galactosyl, glucosyl and neuraminic acid residues, which confer viscoelasticity on the interstitial tissue and participate in substrate transport, hormome binding and cell–cell interaction. Unilateral cryptorchidism did not induce anomalies in extracellular glycans in scrotal testes, but unilateral and bilateral cryptorchidism resulted in an increased content of fucosyl and galactosyl, and a decreased content of glucosyl and neuraminic acid residues in abdominal testes, leading to reduced viscoelasticity and defective substrate transport across the extracellular matrix.

Morphological and histochemical characteristics of the lamina propria in scrotal and abdominal testes from postpubertal boars: correlation with the appearance of the seminiferous epithelium.

This study was undertaken to investigate the morphological characteristics and lectin affinity of the testicular lamina propria in healthy boars and in unilateral and bilateral abdominal cryptorchid boars. The lamina propria of scrotal testes from healthy boars and unilateral cryptorchid boars was constituted by an innermost noncellular layer, the basal lamina, and by 2 layers of peritubular cells, each separated by a fibrous layer. The noncellular layers contained collagen fibres and glycoconjugates with abundant N-acetylgalactosamine, galactose, fucose, N-acetylglucosamine and neuraminic acid residues. The inner peritubular cell layer was composed of myoid cells, the outer layer of fibroblasts. In the abdominal testes of unilateral and bilateral cryptorchid boars, the lamina propria of nondegenerating and degenerating seminiferous tubules appeared thickened due to an increased content of collagen fibres and glycoconjugates. Glycoconjugates showed decreased amounts of fucose, neuraminic acid and galactose, and increased amounts of N-acetylglucosamine residues. The basal lamina formed infoldings toward the seminiferous epithelium and contained small cells. Both inner and outer peritubular cells were fibroblasts of immature appearance. In degenerated seminiferous tubules of bilateral cryptorchid boars, the lamina propria was composed of a thickened and collagenised basal lamina, without peritubular cells and with a low content of glycoconjugates. In scrotal testes, therefore, the lamina propria was implicated in tubular contractility and in mediating the communication and the substrate diffusion between seminiferous tubules and interstitial tissue. Cryptorchidism induced morphological and histochemical alterations in the lamina propria of abdominal testes, which may be linked to evidence from other studies of lack of tubular contractility and defective cell-cell communication and substrate diffusion. The severity of these anomalies correlated with the severity of Sertoli cell alterations.

Diagnosis of Abdominal Bilateral Cryptorchidism: HCG Stimulation Test

A diagnostic stimulation test with hCG (Pregnyl) was performed in clinically healthy boys and was used to diagnose cases of bilateral abdominal cryptorchidism. In clinical andrology, this test may be applied as a noninvasive and highly sensitive method.

Lectin affinity of the seminiferous epithelium in healthy and cryptorchid post‐pubertal boars

The present study describes the sugar content of the seminiferous epithelium, using lectin histochemistry, in healthy boars and in boars with unilateral and bilateral abdominal cryptorchidism. In healthy boars the apical cytoplasm of Sertoli cells exhibited abundant glucosyl (Con A and WGA lectins), galactosyl (HPA, DBA, SBA and PNA lectins), and fucosyl (AAA lectin) residues. Spermatogonia and spermatocytes contained abundant glucosyl (Con A and WGA lectins) and fucosyl (AAA lectin) residues. In spermatids, galactosyl (SBA and PNA lectins) and glucosyl (Con A and WGA lectins) residues increased progressively throughout spermiogenesis, and fucosyl (AAA lectin) residues decreased. As compared with healthy boars, the scrotal testis of unilateral cryptorchid boars showed decreased amounts of fucosyl (AAA lectin) and galactosyl (HPA and DBA lectins) residues on the Sertoli cell apical cytoplasm; spermatocytes exhibited higher content of glucosyl (Con A lectin) residues and spermatids showed altered nature of glucosyl (Con A and WGA lectins) and galactosyl (SBA and PNA lectins) complexes. In abdominal testes of unilateral and bilateral cryptorchid boars, immature Sertoli cells and spermatogonia showed decreased fucosyl (AAA lectin), and increased glucosyl (Con A and WGA lectins) and galactosyl (SBA and PNA lectins) contents. These results suggest that the seminiferous epithelium of healthy boars has polarized activity with the apical compartment implicated in germ cell-Sertoli cell adhesion and interaction, in transport of ions, substrates and fluids, and in acrosomal differentiation. In scrotal testes, unilateral abdominal cryptorchidism could lead to defective germ cell-Sertoli cell adhesion, impaired acrosomal differentiation and increased ionic transport in the apical compartment of the seminiferous epithelium. Unilateral and bilateral cryptorchidism could induce increased ionic transport and membrane permeability in the seminiferous epithelium of abdominal testes.

Different insulin-like 3 (INSL3) gene mutations not associated with human cryptorchidism.

Cryptorchidism is the most frequent congenital anomaly of the urogenital tract in the male, but its etiology is for the most part unknown. Evidence suggests that a possible genetic cause may be involved. Animal models support this hypothesis, and in particular INSL3 (Leydig insulin-like 3 hormone) has been proposed as putative gene for cryptorchidism, since male mice mutant for Insl3 exhibit bilateral abdominal cryptorchidism due to alteration of gubernaculum development. In this study, we analyzed whether mutations in INSL3 could be associated with human cryptorchidism. Heteroduplex analysis and sequencing of both exons of INSL3 in 65 ex-cryptorchid patients and a group of control subjects allowed us to find four nucleotide changes in the sequence of exon I. These mutations are all single base substitutions from G to A at position 27, 96, 126 and 178. Only the 178G-->A substitution changes codon 60 from alanine to threonine (A60T). All mutations were found in comparable distribution in ex-cryptorchid patients and non-cryptorchid men. Therefore, all mutations represent neutral polymorphisms not associated with phenotype. This study confirms previous observations and demonstrates a novel polymorphism in the INSL3 gene. In contrast to that described for the mutant mouse, these data indicate that mutations of INSL3 do not seem to represent a frequent cause of cryptorchidism.

Cytology of the interstitial tissue in scrotal and abdominal testes of post-puberal boars

The interstitial tissue of the testes from healthy boars, and unilateral and bilateral abdominal cryptorchid boars was examined by light and transmission electron microscopy. The left and right testes of healthy boars, and the left (scrotal) testis of unilateral cryptorchid boars had abundant mature Leydig cells, few fibroblasts and mast cells, scarce and small blood vessels, and little lymphatic areas. The right (abdominal) testis of unilateral cryptorchid boars contained abundant Leydig cells, fibroblasts and erythrocytes, scarce mast cells, and frequent blood vessels; Leydig cells exhibited either a mature but degenerative appearance or an immature appearance, and fibroblasts displayed immaturity signs. The interstitial tissue of the left (abdominal) testes of bilateral cryptorchid boars had small blood vessels surrounded by erythrocytes, lymphocytes, and few plasma cells, and abundant mature and immature Leydig cells, immature fibroblasts, and mast cells. Mature Leydig cells showed mid or advanced degeneration, and immature Leydig cells displayed either non-degenerative or degenerative patterns. The right (abdominal) testes of bilateral cryptorchid boars contained scarce immature Leydig cells in advanced degeneration, large fibrous and adipose areas, and blood vessels. These results indicated that unilateral abdominal cryptorchidism affect neither the structural nor the cytologic features of the interstitial tissue in scrotal testes. Unilateral and bilateral cryptorchidism induced abnormal differentiation of Leydig cells and fibroblasts leading to decreased steroid production and increased collagenization in abdominal testes.

Morphologic and histochemical study of blood capillaries in boar testes: effects of abdominal cryptorchidism.

Few data exist about the features of testicular microvasculature under normal and pathologic conditions. The morphology and lectin affinity of testicular capillaries were examined in healthy boars and in unilateral and bilateral abdominal cryptorchid boars. The capillaries of scrotal testes contained a) the endothelial layer formed by two cells, b) the basal lamina constituted by collagen fibers and glycoconjugates with fucosyl, galactosyl, glucosyl, and neuraminic acid residues, and c) the pericyte layer formed by a single cell. These components participated in substrate exchange between blood and testicular tissue. The abdominal testes showed increased numbers of capillaries, which could exhibit a mature appearance, but also angiogenic or degenerative patterns. Angiogenesis was manifested in interstitial capillaries and was characterized by a) proliferation of endothelial cells, b) decreased thickness and decreased content of collagen fibers and glycoconjugates in the basal lamina, and c) lack of pericytes. Degenerative capillaries lay in association with seminiferous tubules and showed a) pyknotic endothelial cells; b) thickening, collagenization, and altered glycoconjugate content in the basal lamina; and c) increased development of pericytes. The angiogenesis of interstitial capillaries resulted in high vascular permeability, and the degeneration of intertubular capillaries led to defective substrate exchange between blood and seminiferous tubules. Unilateral abdominal cryptorchidism did not alter the morphology and function of capillaries in the scrotal testis. Unilateral and bilateral abdominal cryptorchidism resulted in increased numbers and abnormal morphology and function of capillaries in abdominal testes. The proliferation of interstitial capillaries correlated with the immaturity of Leydig cells, and the degeneration of intertubular capillaries correlated with the thickening of the lamina propria.

Histology of the fetal prune belly syndrome with reference to the efficacy of prenatal decompression.

Deficient abdominal musculature, complex abnormalities of urinary tracts and bilateral abdominal cryptorchidism represent the basic characteristics of prune belly syndrome (PBS). Although prenatal diagnosis of PBS is rarely made, because of the wide variety of ultrasonographic images, reported cases have gradually increased. Once a fetus suspected of having PBS is found, it is sometimes difficult for the pediatric urologists to decide how to treat them. The histology of the kidney and urinary tracts in fetuses with PBS was reviewed in order to give suggestions on the management of prenatal cases. Autopsy records of nine fetuses (5 males, 2 females and 2 undetermined) with characteristically distended and deficient abdominal wall were reviewed. Gestational age (GA) at detection ranged from 12 to 25 weeks and at delivery from 13 to 32 weeks. Renal histology in two fetuses showed earlier than normal disappearance of cortical nephrogenic zone replaced by cortical cysts and dysplastic structures. The nephrogenic zone was retained in five fetuses which were younger than GA 20 weeks. While the number of glomeruli along the medullary ray was normal for the age in three fetuses younger than GA 20 weeks, it was decreased in all others. Bladder histology was variable showing both increased musculature and defective or dysplastic muscles. There was a tendency for connective tissues in the bladder wall to increase in proportion to GA, The ureter revealed scarcity of muscle bundles among dense connective tissue. The urethra was atretic in eight fetuses. The clinical implication from the renal histology is that decompression of the urinary tract should be done before GA 20 weeks. However, the early fetal treatment appears to have no effect on the urodynamics in this disorder with deficient musculature.

P-002. Testicular structure in spontaneous unilateral and bilateral abdominal cryptorchidism

P-002. Testicular structure in spontaneous unilateral and bilateral abdominal cryptorchidism

Morphologic study of the testes from spontaneous unilateral and bilateral abdominal cryptorchid boars.

Macroscopical and histological characteristics were examined in both testes from three healthy boars, three boars with unilateral abdominal cryptorchidism on the right side, and three boars with bilateral abdominal cryptorchidism. Abdominal cryptorchidism, unilateral and bilateral, provoked a significant decrease of the weight and volume of the ectopic testes. The scrotal testis of the unilateral cryptorchid boars showed an increase in its volume and weight. Cryptorchidism also induced abnormalities in the histological structure of seminiferous tubules, lamina propria, and interstitial tissue of the abdominal testes. The number of seminiferous tubules decreased; the seminiferous epithelium was constituted by few spermatogonia with an atypical pattern and by abnormal Sertoli cells. The lamina propria showed a variable degree of thickening and collagenization. The interstitial tissue was very developed but displayed a decrease in the Leydig cell population. These abnormalities were more critical in bilateral cryptorchidism than in unilateral cryptorchidism. The scrotal testis of the unilateral cryptorchid boars showed normal appearance, but a decrease of the number of seminiferous tubules was observed. Moreover, the seminiferous tubules showed impaired spermatid maturation. The alterations observed in the abdominal testes of the unilateral and bilateral cryptorchid boars were attributed to defective proliferation and differentiation of Sertoli cells and Leydig cells. The anomalies in the scrotal testis of the unilateral cryptorchid boars were due to disturbances in the Sertoli cell activity.

Bilateral abdominal cryptorchidism in males: autotransplantation of the testis.

5 patients with bilateral abdominal cryptorchidism are reported. Orthotopic autotransplantation of the right testis was performed in 4 cases and both testes in 1 case. Testicular vessels were anastomosed end-to-end with the inferior epigastric vessels. The ischemic testes were cooled to 20 degrees C. The vas was mobilized intact. We discuss the expediency of this organ-preserving operation, the type of vascular anastomosis and the use of local hypothermia.