Dartos Research Articles

Chordee Without Hypospadias in Children

We discuss 20 children who have undergone surgical correction of chordee without hypospadias. In 9 patients ventral curvature was demonstrated secondary to corporeal disproportion, 8 had chordee secondary to deficiency of the dartos fascia (skin chordee) and 3 had deficiency of the dartos and Buck’s fasciae. Eight patients underwent excision of dorsal ellipses according to the Nesbit principle, 8 had lysis of the dartos fascia using the Allen-Spence technique, 2 underwent mobilization of the urethra with excision of underlying fibrous tissue and 2 had division of the urethra with a staged urethroplasty. The majority of cases of chordee without hypospadias are a result of anomalies of the tissue layers of the penis, and adequate straightening can be achieved by excision of underlying abnormal fascial tissue. All patients have achieved a satisfactory cosmetic and functional result with a straight penis and a urethral meatus positioned distally at the glans tip

Electron Microscopic Study of Mineral Deposits in Idiopathic Calcinosis of the Scrotum

AbstractAn excised specimen from a 39-year-old man with idiopathic calcinosis of the scrotum was examined by electron microscopy. Mineral deposits were located in the dermis in which collagen fibers were numerous. Thesecollagen fibers appeared mineralized to varying degrees. Mineral crystals frequently were present in the cytoplasm of fibroblasts near large deposits. The mineral portion was identified as a compound consisting of calcium and phosphorus, and the elementary mapping of calcium and phosphorus in the skin tissue was analyzed by an energy dispersive x-ray spectrometer. No calcification was observed in dartos muscle cells or in mast cells.

Hyalinosis cutis et mucosae

Electron microscopy revealed accumulation of fibrogranular materials associated with laminated basal lamina around the smooth muscle cells of tunica dartos (most strikingly) and of blood vessels, vascular endothelial cells, pericytes, myofibroblasts (not usual fibroblasts) as well as Schwann cells and perineuria. Around the presumably regressive and slightly shrunken sweat duct, a network of basal lamina containing fibrogranular materials was found in a configuration indicating that it would have surrounded the remnants of cells (involuted cells) of the sweat duct, probably consisting of old, undegradated, residual basal lamina. Consequently, it was suggested that hyalinosis cutis et mucosae might be caused by accumulation and invasion of basal lamina glycoprotein involving the type IV (plusV?) collagen into normal collagen fibers (bundles) due to defective degradation.

Leiomyoma of scrotum

Leiomyomas arising from the tunica dartos scroti are rare tumors. We report the first case of bilateral leiomyomas of the scrotum.

Leprosy in peripheral nerves: histopathological findings in 119 untreated patients in Nepal.

From a series of 343 nerve biopsies taken by one clinician over a period of 12 years in Nepal, this paper describes the histopathological findings in 153 biopsies from 119 patients suffering from tuberculoid, borderline (dimorphous) or lepromatous leprosy, who were untreated at the time of first presentation and diagnosis. They were taken during the course of other studies, mainly concerned with the mode of transmission of leprosy, and which included biopsies of skin, dartos muscle, nasal mucous membrane and nipple, results of which have already been published. Examination of serial sections by light microscopy revealed a density of cellular infiltration in non-lepromatous cases, or of bacilli in macrophages and Schwann cells in lepromatous cases, which was marked in degree and usually widespread from one end of the biopsy to the other. Intraneural caseation was recorded in four patients with tuberculoid or borderline-tuberculoid leprosy, and many others in this part of the spectrum showed extensive disruption of perineurial and endoneurial structure. In lepromatous patients, the numbers of bacilli in the endoneurial area not infrequently exceeded one thousand per oil immersion field. Although well known to histopathologists familiar with this disease, it is considered that the significance of these findings, in patients presenting for the first time, is not well appreciated by those working in general medicine, neurology, epidemiology, or even in leprosy control.

Scrotal thermoregulation of the bull (Bos sp.)

A comparison was made of evaporative heat loss from the skin of the scrotum and the thorax of the bull. The sweat glands of the scrotum were not controlled independently of those on the general body surface. Scrotal sweat glands were found to be under adrenergic neural control like those of the general body surface. The large sweat glands of the scrotum produced approximately five times as much sweat per gland as those on the general body surface. Localized heating of the scrotum for 20 min stimulated both panting and sweating without any change in deep body temperature. Insensible moisture loss from the scrotum was greater than that from the skin of the general body surface. It is concluded that there are no fundamental differences in the properties of the sweat glands of the scrotum and those of the general body surface, and that the high insensible moisture loss of the scrotum assists with cooling of the skin of the scrotum. It is suggested that a function of the tunica dartos muscle is to reduce insensible moisture loss.

Leiomyoma of scrotum

A case of leiomyoma of the tunica dartos, a benign lesion arising from the wall of the scrotum and not attached to the epididymis, testicular tunics, or adjacent structures, is presented.

Microscopic anatomy of the scrotum, testis with its excurrent duct system and spermatic cord of Didelphis azarae.

The authors give a description of the microscopic anatomy of the scrotum, testis and its excurrent duct system and the structures of the spermatic cord. The scrotal skin of Didelphis azarae is hairy with the surface marked by shallow grooves and spotted with black pigmented areas. Clear cells and mitotic figures are frequently seen in the basal region. The sweat glands are tubular, apocrine, with alcian-blue- and PAS-positive secretion, presenting large myoepithelial cells. The tunica dartos is poorly developed. The tunica vaginalis is constituted by three layers, presenting patches of melanocytes in variable extensions. The tunica albuginea is composed preponderantly of collage and thin elastic fibers without muscle fibers. The interstitial tissue presents connective cells and a large number of Leydig cells. Mast cells were not observed. The tunica propria of the seminiferous tubuli is fibroelastic with two or three layers of elongated cells. The straight tubuli are divided into three different portions lined by epithelium with variable height. These tubuli at the mediastinum join each other to form a single duct near the cranial pole of the testis. The extratesticular segment of the efferent duct divides initially into two and then into three or four smaller flexuous ductuli to constitute the head of the epididymis. The spermatic cord shows a well-developed cremaster muscle. A collagenous fibrous band separates the muscle from the deferent duct and vessels. Mast cells are observed among the muscle fibers of the cremaster and the tunica adventitia of the blood vessels.

Solitary Leiomyomas Arising from the Tunica Dartos Scroti

Of 127 patients with primary neoplasms of the scrotal wall 10 had a solitary leiomyoma arising from the tunica dartos. These benign asymptomatic lesions occur in middle-age white men and are often incorrectly diagnosed. Simple surgical excision is curative. The 11th case is described because of the malignant course that followed irradiation. A cell arising from single smooth muscle cells within the corium is proposed as the cell of origin.

Morphological analysis of tissue components in the tunica dartos of man

The human tunica dartos has been investigated by light, fluorescence and electron microscopy. It consists of solid bundles of smooth musculature in the subcutis, and small bundles or single muscle cells in the corium. Smooth muscle bundles in both the subcutis and corium are composed of ordinary smooth muscle cells. Single muscle cells of the corium resemble myofibroblasts showing features of fibrocytes and smooth muscle cells. As revealed in single smooth muscle cells, each cell appears to be surrounded by a coat of interweaving microfilaments which penetrate neighbouring bundles of collagen fibres and show inclusions of elastin. Part of the microfilaments extend into the specialized subepithelial connective tissue layer and may insert at the basement membrane. Only ordinary smooth muscle cells have an adrenergic innervation, which indicates their involvement in sympathetic thermoregulatory reflexes.

Orchiopexy: A new anchoring technique, window septopexy

Once the testis can be placed well down in the scrotum without tension, a number of suggestions have been made for keeping it in the orthotopic position. Torek, in 1931, simplistically sutured the testis to the fascia of the ipsilateral thigh, leaving it in this unusual position for several months; 1 it was then released in a second stage, closing the skin of the thigh and scrotum. Experience was dismal, the technique has been discarded, and is mentioned only to be condemned. Cabot and Nesbit, in 1931, recommended the use of a rubber band attached to a silk suture that grasped the tunica albuginea. 2 The elastic in turn was attached to adhesive tape anchored to the inner aspect of the contralateral thigh, with the device left in place for approximately 1 wk. Petrikalsky, 3 in 1931; Schoemaker, 4 in 1932; Lattimer, 5 in 1954; Koop, 6 in 1957; and Benson, 7 in 1967 established a plane between the tunica dartos and the scrotal skin, the testis became a subcutaneous organ, and the dartos was closed superiorly around the cord. Benson, on occasion, used an external button or traction suture in combination with the dartos pouch. Ombredonne, in 1927, drew the testicle through a hole in the scrotal septum, a continuation and coalescence of the tunica dartos from each scrotal pouch, into the contralateral scrotal compartment. 8 The septal window was closed snugly about the cord structures. This appears to be an odd arrangement, especially in the child undergoing bilateral orchiopexy. The Ombredonne procedure was resurrected by Schutt, 9 in 1945; McCormack, 10 in 1959; Miller, 11 in 1967; and Persky, 12 in 1970. These authors stressed the advantages of a short period of hospitalization, no foreign body leading to the outside, and no external appliance. Welch, in 1965, utilizing the same anatominal information, sutured the medial aspect of the tunica albuginea to the margins of a small septal window, leaving the testicle in the ipsilateral scrotal compartment. 3

Testicular temperature in the Southern elephant seal, Mirounga leonina (Linn).

The testes of the Southern Elephant Seal are extra-abdominal, but each is contained in a separate inguinal pouch and not in a single scrotum; they lie beneath the blubber and against the muscles of the abdomen, and it would appear that their position is fixed as there is no evidence of a tunica dartos, and the rudimentary external cremaster muscle consists of a few weak fibres arising from the obliquus internus abdominis. The testicular temperature might therefore be expected to be close to the body temperature. Two mature bull elephant seals were immobilized with succinylcholine chloride (Ling & Nicholls, 1963), and the temperature of the testes was measured by cutting through the blubber layer down to the testicular pouch and passing a thermistor probe approximately 4 cm into the testis, which represented approximately the centre of the testis.