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Testes: Gross Anatomy01:19

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The testes, also known as testicles, are the male gonads. They are housed within the scrotum, a sac-like structure located beneath the penis. The scrotum's primary role is to regulate the temperature of the testes, which is crucial for sperm production.
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A tough, fibrous membrane, the tunica albuginea, covers the testes, extending inward to form fibrous partitions or septa, dividing them into internal compartments called lobules. Each lobule has 1 to 3 tightly coiled seminiferous tubules where sperm production occurs. These tubules merge into a tubular network at the back of the testis, known as the rete testis. It connects to 15 to 20 efferent ductules, leading to the epididymis.
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The Y chromosome is a sex chromosome found in several vertebrates and mammals, including humans. In addition to 22 pairs of autosomes, the human males have one X chromosome and one Y chromosome. In these organisms, the presence or absence of the Y chromosome determines the development of male traits.
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Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...
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Ascending testis: A congenital predetermined condition.

Nasib Alchoikani1, Khaled Ashour2

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|January 23, 2021
PubMed
Summary

Ascending testes in boys may be a congenital condition, not a result of the processus vaginalis. Intra-operative findings suggest abnormal gubernaculum attachment and epididymal fusion are key factors in undescended testes.

Keywords:
Ascending testisGubernaculumProcessus vaginalisUndescended testis

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Area of Science:

  • Pediatric Surgery
  • Urology
  • Developmental Biology

Background:

  • Undescended testes (cryptorchidism) affect approximately 0.8% of boys at one year of age.
  • Orchidopexy rates are significantly higher than expected, with ascending testes accounting for some discrepancy.
  • The exact etiology of ascending testes remains debated, with varying reports on the role of the processus vaginalis.

Purpose of the Study:

  • To investigate the intra-operative findings in patients undergoing orchidopexy for ascending testes.
  • To infer the underlying etiology of ascending testes based on surgical observations.

Main Methods:

  • Observational study of 83 children (85 orchidopexy cases) with confirmed ascending testes over four years.
  • Intra-operative evaluation of gubernacular attachment and epididymal-testicular fusion.
  • Assessment of patent processus vaginalis (PPV) length, looping vas, and hydatid of Morgagni.

Main Results:

  • Abnormal gubernacular attachment was observed in all cases, proximal to the scrotal-thigh junction.
  • Patent processus vaginalis (PPV) was present in all cases, with variable lengths (4-15 mm).
  • Epididymal fusion anomalies were noted in 98.8% of cases; abnormal gubernaculum attachment and epididymal fusion anomalies were consistently found.

Conclusions:

  • Findings suggest ascending testes may be a congenital condition, not solely due to the processus vaginalis.
  • Abnormal gubernacular attachment and epididymal fusion anomalies indicate a predetermined congenital etiology.
  • Ascending testes might represent a condition that becomes more apparent with child growth, rather than a true ascent.