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Orchidopexy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Descent of the testes occurs in two morphologically and hormonally distinct phases. The key structure in controlling the process is the gubernaculum, which is the embryonic ligament anchoring the testis and urogenital ridge to the inguinal region. The gubernaculum enlarges in the first phase to anchor the testis near the inguinal region as the embryo enlarges between 10 and 15 weeks of gestation. In the second phase, which occurs between about 25 and 35 weeks of gestation, the gubernaculum migrates through the inguinal canal, across the pubic region, and into the scrotum. The processus vaginalis (PV) develops as a peritoneal diverticulum within the elongating gubernaculum, creating an intraperitoneal space into which the testis can descend.
Paediatric Urology
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Jemma Hale, Arash K. Taghizadeh
The gubernaculum begins as mesenchymal tissue from the lower pole of the testes and extends into what becomes the scrotum. A pouch of peritoneum extends into the gubernaculum to form the processes vaginalis which then involute behind the testis as it descends into the scrotum.
The urinary tract and male reproductive system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Luis Beltran, Daniel M. Berney
The testis develops embryologically from the genital ridge adjacent to the mesonephros. Germ cells migrate to the genital ridge and are surrounded by proliferating mesothelium to form ‘sex cords’, which will form the seminiferous tubules with Sertoli cells and germ cells. Sertoli cells are essential ‘nurse’ cells for spermatogenesis. Surrounding mesodermal stroma forms the Leydig cells. During intrauterine development the testes descend into the scrotum, apparently guided by an anchoring structure composed of undifferentiated mesenchyme, the gubernaculum.
Plasma concentration of MMP-1 and MMP-2 in boys with cryptorchidism and its lack of correlation with INSL3 and inhibin B
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2019
Ewa Matuszczak, Marta Diana Komarowska, Anna Sankiewicz, Łukasz Ołdak, Ewa Gorodkiewicz, Wojciech Debek, Robert Milewski, Marzena Tylicka, Adam Hermanowicz
During the process of descending to the scrotum, testicles are guided by the gubernaculum, which consists of mesenchymal cells and extracellular matrix [5]. In the postnatal life, the gubernaculum is remodeled as to anchor the testes to the scrotum. Gubernaculum’s maturation and also spermatogenesis demand proper equilibrium of metalloproteinases and their inhibitors [5]. Matrix metalloproteinase 1 membrane type (MMP-1) takes part in the process of descending of the testicles, and matrix metalloproteinase type 2 (MMP-2) takes part in spermatogenesis [6]. Sertoli cells the same as germ cells are attached to the basement membrane, and proteases with their inhibitors play a role during spermatogenesis, enabling the motion of the germ cells in the seminiferous epithelium [7].
Microscopic subinguinal varicocelectomy in 100 consecutive cases: Spermatic cord vascular anatomy, recurrence and hydrocele outcome analysis
Published in Arab Journal of Urology, 2018
Ahmed M. Al-Kandari, Abdulnasser Khudair, Abdelghaffar Arafa, Fouad Zanaty, Ahmed Ezz, Mohamed El-Shazly
We also found that the mean number of cremasteric veins on the left and right sides was 1.4 and 1.2, respectively. Inguinal floor vessels were noted in 9% on the left side and were not seen in the right-side cases. Gubernacular veins were noted in 75% of the cases on the left side, with a mean number of 1.2, and in 85% on the right-side, with a mean of 1. Veins exiting through the gubernaculum were commonly seen in subinguinal studies on average in 71%. It is unclear exactly what role the gubernacular veins have in the pathogenesis of varicoceles and in postoperative varicocele recurrence. In a study by Murray et al. [15], examining varicocele recurrence, scrotal collaterals were presumed to exist in 7% of recurrent varicoceles.
Evaluation of the correlation between insulin like factor 3, polycystic ovary syndrome, and ovarian maldescent
Published in Gynecological Endocrinology, 2018
Normal ovarian descent is supposed to be guided with a cord of mesenchyme connecting the lower pole of the ovaries to the uterus, which would be called later on the gubernaculum, and eventually would form utero-ovarian and round ligaments. Hutson et al. previously had suggested that the first phase of ovarian descent is controlled by a Mullerian inhibiting substance (MIS), although this still remains controversial, while the second phase had proposed to be androgen dependent, and is possibly mediated indirectly through the release of a gene-related neuropeptide, from the genitofemoral nerve stimulation [4–6].