Pubertal genitofemoral nerve division induces testicular ascent in adult rats

Infertility in rats subjected to genitofemoral nerve section is not associated with testicular damage

This work was aimed at assessing the relationship between testicular ascent and infertility induced by genitofemoral nerve (GFN) section in rats. Eighteen male rats were assigned to three experimental groups as follows: (i) Group SGFN was subjected to surgical section of genitofemoral nerve; (ii) Group Sham; (iii) Control group. The GFN was cut at puberty (28D), and the contralateral testis removed at 90D, with fertility tests at 120D. At 150D, maturity index, epithelial area and histopathological index of seminiferous tubules of all rats were determined and statistically compared between superior and inferior testicle poles, and between groups. There were no differences in testicular parameters, sperm morphology or sperm concentrations (P > 0.05). Section of NGF interfered with fertility (58.3 ± 15.4 in SGFN versus 83.3 ± 10.5 in Sham) and litter size (6.2 ± 1.1 in SGFN versus 10.7 ± 1.4 in Sham). Cremaster of SGFN group showed early neuropathy. The GFN section induced partial testicular ascent and diminished fertility without damage on testicular morphology or spermatic parameters, because, cremaster could affect the contractibility and ejaculation mechanisms in which it participates. The study of the damage on cremaster induced by an injury on GFN could have an overview of the mechanisms inherent in the testicular ascent induced by this iatrogenic alteration and their potential risks on fertility.

Incidence of Testicular Ascent in Boys With Retractile Testes

PURPOSE

The incidence of testicular ascent of a previously descended but retractile testis is reported to be between 2% and 45%. It has been our bias that only a small percent of retractile testes ascend and ultimately require orchiopexy.

MATERIALS AND METHODS

We performed a retrospective review of all retractile testes diagnosed by any of 4 pediatric urologists at our institution from 1996 to 2005. A retractile testis was defined as one that could be brought to at least the mid scrotum without tension despite a history of maldescent or a retractile nature. Patients were excluded if followup was less than 6 months or they had a history of ipsilateral inguinal surgery. A followup telephone survey was done in patients not reexamined at resolution.

RESULTS

A total of 172 patients met our inclusion criteria and were followed to resolution. A total of 274 retractile testes were initially identified, including 26% unilateral and 74% bilateral testes. A total of 19 testes ascended and ultimately required orchiopexy within a followup of 6 to 101 months. A patent processus vaginalis was identified in 13 cases (68%). Another 235 patients initially seen with a diagnosis of retractile testis who had no followup examination at our institution were contacted via telephone. This set of boys initially had a total of 392 involved testes, of which 2 underwent orchiopexy elsewhere before resolution. The incidence of secondary ascent was 3.2% in the combined set of patients.

CONCLUSIONS

Retractile testes can ascend and, therefore, they require followup until resolution. In our experience most retractile testes do not require surgery.

Ascended testis in three brothers with Pelizaeus Merzbacher syndrome

Ascended testis is a rare clinical entity. The mechanism involved in testicular ascent is still not understood completely. Spasticity of cremaster muscle may cause secondary ascent of testis. The authors present 3 brothers with Pelizaeus Merzbacher syndrome, a rare, x-linked leukodystrophy in whom the testes bilaterally ascended from the normal scrotal position to an undescended position after onset of spasticity.