Inguinal Undescended Testes Research Articles

Management strategy for high inguinal testis in a 9-year-old child: A case report

Abstract The high inguinal undescended testis is a unique clinical entity necessitating additional surgical procedures. Since the testis cannot be implanted in the scrotal sac due to the short testicular artery, transection of the artery (Fowler and Stephens procedure) is a viable alternative. The Fowler and Stephens procedure, either one- or two-stage, has remarkably good success rates, up to 80% for one-stage and 85% for two-stage. We present a 9-year-old child with high inguinal testis who underwent a one-stage open Fowler and Stephens orchiopexy to bring the testis into the scrotum.

Benign Prostatic Hyperplasia in a 13-Year-Old Boy

Benign prostatic hyperplasia (BPH) is most common in men 40 years and above. It rarely occurs in childhood. As a result of the scarcity of cases, the pathogenesis is not clear, and treatment of BPH in this age group is challenging. This report focuses on a 13-year-old patient diagnosed with a histologically confirmed BPH, having presented with a 2-year history of recurrent hematuria and acute urinary retention. Magnetic resonance imaging (MRI) revealed a 287 g prostatic mass, with no signs of malignancy nor metastasis detected. A decision for open suprapubic prostatectomy was made. Postoperative follow-up at 1 year was uneventful. The possible causes of juvenile BPH have been postulated as gonadotropin supplementation for cryptorchidism and human chorionic gonadotropin-containing agent use by the mother during pregnancy. Our case had a history of the right inguinal undescended testis with scrotal orchidopexy done at 11 years of age. However, the patient had no history of human chorionic gonadotropin use, endocrinologic abnormality, or other possible contributing factors. His antenatal history was normal, with no use of human chorionic gonadotropin by the mother. Due to the very few reported cases, there is insufficient data to help understand the pathogenesis of childhood BPH.

The effect of scrotal versus inguinal orchiopexy on the testicular function of children with clinically palpable, inguinal undescended testis: a randomized controlled trial.

To compare the impact of the scrotal vs inguinal orchidopexy approach on the testicular function of infants with cryptorchidism, a randomized controlled trial was conducted involving boys who were 6-12 months old at surgery and were diagnosed with clinically palpable, inguinal undescended testis. Between June 2021 and December 2021, these boys at Fujian Maternity and Child Health Hospital (Fuzhou, China) and Fujian Children's Hospital (Fuzhou, China) were enrolled. Block randomization with a 1:1 allocation ratio was employed. The primary outcome was testicular function assessed by testicular volume, serum testosterone, anti-Müllerian hormone (AMH), and inhibin B (InhB) levels. Secondary outcomes included operative time, amount of intraoperative bleeding, and postoperative complications. Among 577 screened patients, 100 (17.3%) were considered eligible and enrolled in the study. Of the 100 children who completed the 1-year follow-up, 50 underwent scrotal orchidopexy and 50 underwent inguinal orchidopexy. The testicular volume, serum testosterone, AMH, and InhB levels in both groups increased markedly after surgery (all P < 0.05), but there were no apparent differences between groups at 6 months and 12 months after operation (all P > 0.05). No differences between the scrotal and inguinal groups were noted regarding the operative time ( P = 0.987) and amount of intraoperative bleeding ( P = 0.746). The overall complication rate (2.0%) of the scrotal group was slightly lower than that of the inguinal group (8.0%), although this difference was not statistically significant ( P > 0.05). Both scrotal and inguinal orchiopexy exerted protective effects on testicular function in children with cryptorchidism, with similar operative status and postoperative complications. Scrotal orchiopexy is an effective alternative to inguinal orchiopexy in children with cryptorchidism.

PD06-11 LOSS OF WNT4 IN THE GUBERNACULUM CAUSES UNILATERAL CRYPTORCHIDISM AND FERTILITY DEFECTS DUE TO IMBALANCE OF MALE AND FEMALE GENES

You have accessJournal of UrologyCME1 Apr 2023PD06-11 LOSS OF WNT4 IN THE GUBERNACULUM CAUSES UNILATERAL CRYPTORCHIDISM AND FERTILITY DEFECTS DUE TO IMBALANCE OF MALE AND FEMALE GENES Abhishek Seth, Hunter Flores, Ahmed Chahdi, and Carolina Jorgez Abhishek SethAbhishek Seth More articles by this author , Hunter FloresHunter Flores More articles by this author , Ahmed ChahdiAhmed Chahdi More articles by this author , and Carolina JorgezCarolina Jorgez More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003230.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Undescended testis (UDT) is the most common urological birth defect affecting 6% of male births. Despite surgical correction, some men with unilateral UDT may experience infertility with the contralateral descended testis (CDT) showing no A-dark spermatogonia. We hypothesized that WNT4 plays a significant role in gonadal development since mutations in WNT4 are associated with ambiguous genitalia, and overexpression of WNT4 in mice deficient in E2F1 leads to infertility. METHODS: A Wnt4 gubernaculum-specific knock-out mouse was created and phenotyped by crossing RARß2-cre mice to Wnt4-flox mice. Fertility was determined by 6-month paired mating of a wild type (WT) female to a Wnt4f/f;cre+ (Wnt4-cKO) male. RESULTS: All Wnt4-cKO mice presented with a smaller left unilateral UDT, and an equal number of mice had inguinal vs. abdominal UDT. The abdominal UDT had a Sertoli cell-only phenotype. The inguinal UDT had a combination of normal and abnormal seminiferous tubules (ST), including maturation arrest. Half of the mice with inguinal UDT had no sperm in the left epididymis, and the ones with sperm had 33% fewer sperm with a 96% decrease in motility compared to those of WT mice. The left gubernaculum of Wnt4-cKO was longer and thinner with increased collagen and reduced muscle content compared to the right CDT. The fertility of the Wnt4-cKO male was significantly reduced as they produced 23 litters and 88 pups within the same time that 8 WT mice produced 48 litter and 395 pups. Wnt4-cKO mice with abdominal UDT had an increase in serum FSH and LH. Wnt4-cKO UDT and CDT had an increase in ER-a in Leydig cells. Wnt4-cKO CDT and inguinal UDT had an increase in the number of SOX9-positive cells in which SOX9 expression was high in both the cytoplasm and nucleus. Wnt4-cKO testes revealed an up-regulation of genes essential for female gonadal development and function, such as Rspo1, Wnt4,and Foxl2 in both CDT and UDT. Several WNT4 variants were identified in boys with UDT that could potentially cause or contribute to their condition. CONCLUSIONS: Conditional loss of Wnt4 in the gubernaculum leads to aberrant testicular decent and development unilaterally. Although these mice have one normal descended testis, the existence of fertility defects and molecular alterations in the CDT supports our hypothesis that unilateral UDT is a bilateral defect. Our results indicate that the androgen-estrogen imbalance affects both testes and suggest that estrogen impacts the ability of SOX9 to translocate into the nucleus to activate the male developmental pathway. Source of Funding: NIH grant 1R01HD100985 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e160 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Abhishek Seth More articles by this author Hunter Flores More articles by this author Ahmed Chahdi More articles by this author Carolina Jorgez More articles by this author Expand All Advertisement PDF downloadLoading ...

Comparative Study between Laparoscopic versus Open Orchiopexy in Peeping and High Inguinal Undescended Testis: Review article

Comparative Study between Laparoscopic versus Open Orchiopexy in Peeping and High Inguinal Undescended Testis: Review article

Loss of WNT4 in the gubernaculum causes unilateral cryptorchidism and fertility defects.

Undescended testis (UDT) affects 6% of male births. Despite surgical correction, some men with unilateral UDT may experience infertility with the contralateral descended testis (CDT) showing no A-dark spermatogonia. To improve our understanding of the etiology of infertility in UDT, we generated a novel murine model of left unilateral UDT. Gubernaculum-specific Wnt4 knockout (KO) mice (Wnt4-cKO) were generated using retinoic acid receptor β2-cre mice and were found to have a smaller left-unilateral UDT. Wnt4-cKO mice with abdominal UDT had an increase in serum follicle-stimulating hormone and luteinizing hormone and an absence of germ cells in the undescended testicle. Wnt4-cKO mice with inguinal UDT had normal hormonal profiles, and 50% of these mice had no sperm in the left epididymis. Wnt4-cKO mice had fertility defects and produced 52% fewer litters and 78% fewer pups than control mice. Wnt4-cKO testes demonstrated increased expression of estrogen receptor α and SOX9, upregulation of female gonadal genes, and a decrease in male gonadal genes in both CDT and UDT. Several WNT4 variants were identified in boys with UDT. The presence of UDT and fertility defects in Wnt4-cKO mice highlights the crucial role of WNT4 in testicular development.

Anatomical Laparoscopic Orchiopexy and Hybrid Transscrotal Orchiopexy for High Inguinal Undescended Testis: A Novel and Interfascial Technique.

Background: In traditional laparoscopic orchiopexy for inguinal undescended testis (UDT) surgery, the testicles are pulled back into the abdominal cavity by grasping and cephalad retracting the testicle and the cord. If this fails, a subsequent open inguinal incision is made to complete orchiopexy. To improve the orchiolysis and avoid extra open inguinal incision, we describe our early experience with and illustrate the surgical procedure of a novel anatomical laparoscopic orchiopexy (ALO) and hybrid transscrotal orchiopexy as required in high palpable UDT. Methods: From March 2018 to April 2020, ALO was performed in 140 consecutive patients (158 testes) with high inguinal UDT. After blunt and bloodless dissection of the inter-tunica vaginalis-cremasteric fascia plane, tunica vaginalis enveloping the testis was brought into the abdominal cavity as a whole. When the tunica vaginalis was unable to be brought into the abdominal cavity, given that the orchiolysis had already been partially carried out, the testis could be brought out of the external ring and descended when converting to transscrotal surgery. Results: The mean age in this study was 1.88 years (standard deviation ±1.95). The position of the testis assessed at surgery was peeping (58, 36.7%) and canalicular (100, 63.3%). In 128 testes (81.1%), ALO brought the UDT into the abdominal cavity; the remaining 30 testes (18.9%) required a hybrid transscrotal technique. All testes were descended without conversion to open inguinal procedure. The mean operative time was 43.9 ± 9.2 minutes. All patients had follow-up within a median of 17.8 months, with satisfactory results in relation to viability and location of the testis. Conclusions: ALO was shown to be not only safe, feasible, and effective for high inguinal UDT but also facilitated subsequent hybrid transscrotal orchiopexy; when the testis failed to be pulled into the abdominal cavity, the conversion to open inguinal orchiopexy could be obviated.

Abstract 82: Rare case of 46XY OVO testicular DSD

A 5-month-old term baby was referred for ambiguous genitalia. Examination showed a right descended gonad, and an empty scrotum and an inguinal swelling on the left, no phallus and single external urogenital opening in the perinium with an EMS score of 2.5. Possibilities considered included ovo-testicular DSD, PAIS and testosterone biosynthetic defects. Beta HCG Stimulation test ruled out synthetic defects and with good testosterone response. USG abdomen/scrotum showed left inguinal undescended testes. Post Acton prolongatum stimulated cortisol was 43 mcg/dL and the Karyotyping was 46 XY. Diagnostic laparoscopy showed a left sided ovotestes with fallopian tube-like structure attached; and biopsy of gonad confirmed both ovarian and testicular tissue. Hence diagnosis of 46 XY Ovo testicular DSD was made; one which accounts for 3-10% of total DSD. We report this instance where absence of phallic structure is a rare presentation among cases of 46XY Ovo testicular DSD.

Cryptorchid testicular torsion: a case report

Torsion of undescended testis is an uncommon surgical emergency rarely documented. We report a case of a 17 years old patient with an acute inguinal pain with an empty hemiscrotum related to torsion of an inguinal undescended testis. We discuss the clinical presentation, paraclinical investigation, and the outcome after surgery. Our objective is to highlight the importance of a meticulous clinical examination in front of inguinal pain.

A Rare Cause of Acute Abdomen: Testicular Torsion in an Inguinal Undescended Testis

Testicular torsion is well-known urologic emergency. It warrants urgent diagnosis and surgical intervention for successful outcomes. The incidence of undescended testis in new born is 2%-8% and reduces to <1% by 1 year of age. In majority of cases, it is located in inguinal canal. Though undescended testis is a known risk factor for testicular torsion, there are limited cases reports in the literature. Testicular torsion in undescended testis is difficult to diagnose due to vague symptoms and absence of testicular signs. We report a unique case of testicular torsion in an inguinal undescended testis in a 14-year young male.

Comparison of diagnostic and treatment guidelines for undescended testis.

Cryptorchidism or undescended testis is the single most common genitourinary disease in male neonates. In most cases, the testes will descend spontaneously by 3 months of age. If the testes do not descend by 6 months of age, the probability of spontaneous descent thereafter is low. About 1%–2% of boys older than 6 months have undescended testes after their early postnatal descent. In some cases, a testis vanishes in the abdomen or reascends after birth which was present in the scrotum at birth. An inguinal undescended testis is sometimes mistaken for an inguinal hernia. A surgical specialist referral is recommended if descent does not occur by 6 months, undescended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. International guidelines do not recommend ultrasonography or other diagnostic imaging because they cannot add diagnostic accuracy or change treatment. Routine hormonal therapy is not recommended for undescended testis due to a lack of evidence. Orchiopexy is recommended between 6 and 18 months at the latest to protect the fertility potential and decrease the risk of malignant changes. Patients with unilateral undescended testis have an infertility rate of up to 10%. This rate is even higher in patients with bilateral undescended testes, with intra-abdominal undescended testis, or who underwent delayed orchiopexy. Patients with undescended testis have a threefold increased risk of testicular cancer later in life compared to the general population. Self-examination after puberty is recommended to facilitate early cancer detection. A timely referral to a surgical specialist and timely surgical correction are the most important factors for decreasing infertility and testicular cancer rates.

Circumcision-incision orchidopexy: A novel technique for palpable, low inguinal undescended testis

Given that both orchidopexy and circumcision are commonly done in a single operative setting, we adopted a technique of combined orchidopexy and circumcision using a single circumcision incision. We applied this new technique to boys with palpable, low inguinal cryptorchidism. Here we describe a case series of 7 boys who underwent concurrent orchidopexy via the circumcision site. We present this novel technique and discuss our preliminary outcomes, including the anatomic basis and feasibility. The technique appears to be an alternative for concurrent circumcision and cryptorchid cases with palpable, low inguinal testes.

Testicular rerouting by modified Prentiss maneuver: Usefulness in bilateral synchronous orchidopexy for high inguinal undescended testes

ObjectivesTo describe our experience and illustrate the surgical procedure of synchronous bilateral testicular rerouting in high inguinal undescended testes (HIUT) by extending the use of “modified Prentiss maneuver” in bilateral situation, to establish this as a procedure of choice in bilateral HIUT and secondly to demonstrate the length gained by maneuver itself. MethodsBetween January 2011 and December 2012 ten boys (8months–6years) with diagnosis of bilateral HIUT were included in the study. Bilateral orchidopexy was done by "modified Prentiss maneuver" under general anesthesia. Postoperatively all patients were evaluated at 3months ,6months and 1year by physical examinations and ultrasound. ResultsIt was possible to reroute the testes underneath inferior epigastric artery (IEA) without its mobilization and thus locate testicular pedicle through a fascial hole above pubic tubercle, well medial to IEA. The average gain in scrotal positioning was 16mm (10–22mm).No retractions, atrophy of testis, clinical weakness of anterior abdominal wall or inguinal herniation was noted in any patient up to one year follow up. ConclusionsTesticular re-routing by "modified Prentiss maneuver" is a simple, feasible, safe and efficient method for bilateral orchidopexy in bilateral HIUT. Preserving the inferior epigastric artery bilaterally has physiologic advantages.

1529 OPENING THE INGUINAL CANAL IS UNNECESSARY IN INGUINAL ORCHIOPEXY

You have accessJournal of UrologyPediatrics: Congenital Anomalies - Lower Urinary Tract & Genitalia I1 Apr 20121529 OPENING THE INGUINAL CANAL IS UNNECESSARY IN INGUINAL ORCHIOPEXY Frank J. Penna, Jack S. Elder, and Mireya Diaz Frank J. PennaFrank J. Penna Detroit, MI More articles by this author , Jack S. ElderJack S. Elder Detroit, MI More articles by this author , and Mireya DiazMireya Diaz Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1297AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In boys with an inguinal testis, the traditional approach is to perform an inguinal incision, open the inguinal canal, mobilize the testis and spermatic cord, repair the inguinal hernia if present, and place the testis in a dartos pouch in the scrotum. In boys, the inguinal canal is short and during inguinal hernia repair, it is often unnecessary to extend the dissection to the internal inguinal ring in order to mobilize enough length. The purpose of this study is to determine if performing a modified inguinal orchiopexy (without opening the inguinal canal) results in a successful orchiopexy. METHODS Boys with an inguinal testis who underwent orchiopexy were reviewed retrospectively. Patient age and surgical approach (inguinal, with or without inguinal dissection, or prescrotal) were recorded. Only if the testis did not reach the dartos pouch was the inguinal canal opened and a standard orchiopexy performed with inguinal dissection. Presence of an inguinal hernia was also noted. All patients underwent clinical follow-up at 4-6 weeks. Boys with an ectopic, abdominal or absent testis and those undergoing previous inguinal surgery were excluded. RESULTS A total of 254 boys with 323 undescended inguinal testes were reviewed. The results are shown in Table 1. Overall, 171 underwent a modified inguinal orchiopexy without opening the inguinal canal, 36 underwent inguinal orchiopexy with standard inguinal dissection, and 116 underwent prescrotal orchiopexy. A total of 123 (38.1%) testes were associated with an inguinal hernia that was repaired during orchiopexy. Of those with a hernia, 92 underwent a modified inguinal orchiopexy, 23 underwent a standard inguinal orchiopexy, and 9 were corrected via a prescrotal approach. There was one complication of testicular re-ascent in the modified inguinal orchiopexy group. Inguinal (M) Inguinal (S) Prescrotal Total No. testis 171 36 116 323 Mean age (yrs.) 5.1 5.9 4.9 5.1 Hernia 92(54%) 23(64%) 9(8%) 123(38%) No. side Lt 79 20 56 155 Rt 92 16 60 168 No. complications 1(0.5%) 0(0%) 0(0%) 1(0.3%) (M) = modified, (S) = standard CONCLUSIONS In boys with an inguinal undescended testis, orchiopexy can be performed without opening the inguinal canal, even if there is an associated inguinal hernia, with the decision being dependent upon the ability to mobilize the testis and spermatic cord into the dartos pouch. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e619 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Frank J. Penna Detroit, MI More articles by this author Jack S. Elder Detroit, MI More articles by this author Mireya Diaz Detroit, MI More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

Evaluation of Orchidopexy with or without Opening the External Oblique Fascia in Children with Superficial Inguinal Undescended Testis

Orchidopexy is one of the most common pediatric surgeries. In general, the operation for truly undescended testis (UDT) includes opening of the external oblique fascia. The most common location of the testis in UDT is adjacent to the external inguinal canal (superficial inguinal type). Using a new method we performed orchidopexy without opening the fascia. In this clinical trial we compared the outcome after a classic procedure with that obtained using our method. This clinical controlled trial was undertaken in the Al Zahra hospital between 2008 and 2010. Patients were randomized into either into the closed technique group (group A, n=52) or the open group (group B, n=52). The incidence of short-term and long-term complications was recorded with a specific questionnaire at the time of surgery and at follow-up visits. Data were analyzed with the SPSS 15.0 software using chi-square and t-tests. 104 patients were included in this study. The incidence of short-term complications (surgical site hematoma, surgical wound infection, scrotal hematoma) and long-term complications (testicular atrophy) did not differ significantly between the 2 groups. Procedure duration in group A was significantly shorter than in group B (p=0.001). Medial thigh sensory loss was more common in group B (p=0.05). When investigating the surgical management of undescended testes, our study found differences in medial thigh sensory loss rate and procedure duration between the open and closed techniques. Operative treatment of UDT without opening the external oblique fascia is highly recommended.

Re The lost testis: Failure of physical examination and diagnostic laparoscopy to identify inguinal undescended testis, P.I. Ellsworth and L. Chenck, Vol 5 (4) 321–323

Re The lost testis: Failure of physical examination and diagnostic laparoscopy to identify inguinal undescended testis, P.I. Ellsworth and L. Chenck, Vol 5 (4) 321–323

The lost testis: Failure of physical examination and diagnostic laparoscopy to identify inguinal undescended testis

Children presenting with nonpalpable undescended testes are evaluated with diagnostic laparoscopy. The laparoscopic findings of blind-ending vessels and vas deferens are felt to be diagnostic for 'vanished' testes. We present a case of an overweight male in whom the testis was not palpable in the office or under anesthesia and in whom blind-ending vessels were identified on laparoscopy. Inguinal exploration revealed a normal appearing inguinal testis. Although not advocated as a tool in the evaluation of the child presenting with an undescended testis, inguinal ultrasound may have a role in overweight children in whom the examination may be difficult. Furthermore, we would advocate inguinal exploration in overweight children, given the limitations of laparoscopy in this overweight child.

Antiandrogen Induced Cryptorchidism in the Pig is Associated with Failed Gubernacular Regression and Epididymal Malformations

Purpose Can antiandrogens cause cryptorchidism in an animal model with a strip-like gubernaculum? If so, what anatomical abnormalities are associated with cryptorchidism? Materials and Methods Timed pregnant sows received the antiandrogen flutamide during defined gestational intervals. Fetal pigs were evaluated for the presence of testicular undescent and for morphological paratesticular abnormalities at 110 days of gestation (birth). Results Of 180 testes 84 (47 percent) were undescended and 9 (5 percent) were in the abdominal cavity. No undescended testis (0 of 200 testes) was found in control animals (p less than 0.001). Epididymal anomalies were found in all intra-abdominal testes, which was significant when compared to the epididymal abnormalities found with inguinal undescended testes (0 percent) or descended testes (1 percent) (p less than 0.001). Alterations in gubernacular morphology, in particular failure of gubernacular regression, were also directly associated with cryptorchidism (p less than 0.001). Conclusions Androgens partially control transabdominal and transinguinal descent of the porcine testis. In addition, antiandrogen induced cryptorchidism is associated with epididymal malformation and failure of gubernacular regression. It remains to be determined if these latter findings are only associated with or the cause of testicular undescent.

Antiandrogen induced cryptorchidism in the pig is associated with failed gubernacular regression and epididymal malformations.

Can antiandrogens cause cryptorchidism in an animal model with a strip-like gubernaculum? If so, what anatomical abnormalities are associated with cryptorchidism? Timed pregnant sows received the antiandrogen flutamide during defined gestational intervals. Fetal pigs were evaluated for the presence of testicular undescent and for morphological paratesticular abnormalities at 110 days of gestation (birth). Of 180 testes 84 (47%) were undescended and 9 (5%) were in the abdominal cavity. No undescended testis (0 of 200 testes) were found in control animals (p < 0.001). Epididymal anomalies were found in all intra-abdominal testes, which was significant when compared to the epididymal abnormalities found with inguinal undescended testes (0%) or descended testes (1%) (p < 0.001). Alterations in gubernacular morphology, in particular failure of gubernacular regression, were also directly associated with cryptochidism (p < 0.001). Androgens partially control transabdominal and transinguinal descent of the porcine testis. In addition, antiandrogen induced cryptorchidism is associated with epididymal malformation and failure of gubernacular regression. It remains to be determined if these latter findings are only associated with or the cause of testicular undescent.

DNA and RNA Synthesis by Postpubertal Undescended Testis In Vitro

To study the spermatogenic potential of postpubertal undescended testis, the 3H-thymidine and 14C-uridine incorporations into normally descended and inguinal undescended testes were examined. The results suggest that DNA synthesis by the inguinal undescended testis is remarkably inhibited but, on the contrary, RNA synthesis is not. The cell-proliferative ability of postpubertal undescended testis may be impaired in spite of the retention of cell viability in the testis.