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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
A very simplified account of the embryology of differentiation follows. The foetus will develop by default into a female. The mesonephric duct (precursors of uterus and upper vagina) are initially present in both males and females. Secretion of Müllerian Inhibiting Substance (MIS) from the Sertoli cells from 7 weeks will cause regression of the mesonephric duct structures in boys. Androgens, and especially dihydroxy-testosterone are responsible for the development of the external genitals in males.
The urinary and reproductive systems and the external genitalia
Published in Frank J. Dye, Human Life Before Birth, 2019
The ducts of both males and females arise from intermediate mesoderm, close to the splanchnic mesoderm from which the gonads arise. Two pairs of ducts arise side by side from the intermediate mesoderm: the mesonephric ducts and the müllerian ducts (see Figure 18.4A). The mesonephric ducts, as previously discussed, contribute to the formation of the mesonephros.
Reproductive System and Mammary Gland
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Justin D. Vidal, Charles E. Wood, Karyn Colman, Katharine M. Whitney, Dianne M. Creasy
The mesonephric (Wolffian) ducts are aligned longitudinally within the intermediate mesoderm of the fetus, with mesonephric tubules extending medially. Under the influence of testosterone, mesonephric tubules fuse with gonadal cords to form the efferent ductules. The mesonephric duct forms the epididymis, vas deferens, and seminal vesicle. Antimüllerian hormone released by Sertoli cells causes regression of the paramesonephric (Müllerian) ducts.
A case report of first hearing loss, then painful menarche: a young girl with Herlyn–Werner–Wunderlich syndrome (OHVIRA syndrome) and concomitant inner ear anomalies
Published in Journal of Obstetrics and Gynaecology, 2021
Ayşe Ö. Balık, Buket Yağcı, Murat Özoğul, Fisun Vural
Approximately, 10% of all Mullerian ducts anomalies are caused by HWWS (Cox and Ching 2012). The Mullerian canals move towards the midline and then fuse to create uterus, cervix and upper part of the vagina in the eighth to ninth week of embryogenesis. In the case of when the mesonephric duct is absent, the Mullerian duct is displaced laterally and cannot fuse with the contralateral duct, resulting in a didelphic uterus. The contralateral Mullerian duct gives rise to the vagina, whereas the displaced Mullerian duct that cannot come into contact with the urogenital sinus centrally forms a blind sac, leading to an imperforate or obstructed hemivagina. Ipsilateral renal agenesis is the part of the syndrome. Therefore, mesonephric duct evolution anomalies may be the reason for unilateral renal agenesis with imperforate hemivagina (Zhou et al. 2014).
MRI image features and differential diagnoses of Herlyn–Werner–Wunderlich syndrome
Published in Gynecological Endocrinology, 2020
Jinlong Zhang, Shengfang Xu, Lei Yang, Yue Songhong
HMMS is caused by abnormal partial fusion of the bilateral paramesonephric duct with the low incidence of 0.1–3.8% [1–4], and the embryonic development is as a hot topic for research throughout the world. Its main characteristics are a double uterus, double cervix, and double vagina and complete or incomplete atresia of one vagina. HMMS is often accompanied by an oblique septum side kidney and ureter agenesis or other syndromes characterized by genitourinary malformations. The mesenchyme–mesoderm structure becomes the urogenital ridge at about the fifth week of embryonic development, and the mesonephric and Mullerian ducts are gradually formed. For females, the former develops into the urinary system, while the latter develops into the reproductive system. The development of the Mullerian ducts depends on that of the mesonephric duct. When one side of the mesonephric duct is not fully developed because of various factors, development of the ipsilateral Mullerian duct will be affected, which can result ina series of deformities of the kidney, ureter, uterus, and vagina [3–8]. Abnormal muller's disease will lead to infertility, frequent abortion, premature rupture of placenta, premature rupture of fetal membrane, placenta retention, postpartum hemorrhage, fetal abnormal performance, intrauterine growth restriction, increased fetal mortality and other obstetric complications. Recent cases of HWWS complicated with spontaneous abortion, fetal abnormality and premature birth have been reported.
A cross-sectional study of the genital duct and renal anomalies in Egyptian cases of congenital absence of the vas deferens
Published in Human Fertility, 2022
Taha AbdElnaser, Yasser Ibrahem Elkhiat, Hatem Mohamed El-Azizi, El Fatah, Mohamed Abd, Ahmed Mahmoud Elshibany, Sameh Fayek GamalEl Din
Congenital absence of the vas deferens (CAVD) is a relatively rare bilateral (CBAVD) or unilateral (CUAVD) anomaly that may contribute to male infertility. CBAVD is the most common cause of extra-testicular ductal system obstruction affecting about 1–2% of infertile males, 4–17% of males with azoospermia, and 25% of males with obstructive azoospermia (Mittal et al., 2017). However, the real prevalence of CUAVD is unclear, as some men with CUAVD may have normal fertility status and no symptoms (Akinsal et al., 2018). Each mesonephric duct (Wolffian duct) is the source of two physically isolated derivatives: the ipsilateral ureteral/renal system and most of the ipsilateral genital duct (Akinsal et al., 2018). Previous studies indicated that congenital absence of the male genital duct system could occur separately or in combination with renal agenesis or malformations (Esteves, 2016). CAVD is generally identified during the evaluation of infertility or as an accidental finding at the time of a surgical procedure of the urogenital zone, such as orchidopexy or vasectomy (Ong et al., 2017). CAVD can be unilateral or bilateral and partial or complete, and it can be associated with epididymal hypoplasia or other abnormalities including seminal vesicles and ejaculatory duct anomalies and cryptorchidism (Khan & Novell, 2001). Although CAVD is usually not difficult to diagnose, it may be missed due to a poor (or no) physical examination taking place. Renal agenesis is the most common renal anomaly that can be seen with CAVD (Salwan & Abdelrahman, 2017). Nevertheless, several publications documented many other associated anomalies including ectopic kidney, multicystic kidney, horseshoe kidney and malrotation of the solitary kidney (Salwan & Abdelrahman, 2017).