Hadziselimović F, Herzog B, Huff D S, Menardi G
Kinderspital, Basel, Switzerland.
J Urol. 1991 Aug;146(2 ( Pt 2)):627-9. doi: 10.1016/s0022-5347(17)37875-8.
The underlying injury to undescended testes may be hormonal, a transient perinatal form fruste of hypogonadotropic hypogonadism characterized by blunting of the surge in gonadotropins normally seen at age 60 to 90 days. Ischemia is the underlying injury to testes associated with incarcerated inguinal hernias. To determine if the histopathology of these 2 injuries is different histomorphometric analyses were performed on semithin microscopic sections of biopsies of 21 control testes, 17 undescended testes and 13 intrascrotal testes associated with incarcerated inguinal hernias. The infants in all groups were 30 to 120 days old. The results showed that, as in previous studies, undescended testes at this age are characterized by hypoplasia of Leydig cells, normal germ cell counts and defective maturation of gonocytes into adult dark spermatogonia. In contrast, testes associated with incarcerated inguinal hernias were characterized by hyperplasia of Leydig cells, reduced germ cell counts and normal maturation of gonocytes into adult dark spermatogonia. One might conclude that the underlying injury of undescended testes, presumably the blunted surge of gonadotropins, causes a primary hypoplasia and hypofunction of Leydig cells, which in turn causes a secondary defect in transformation of gonocytes into spermatogonia. In contrast, ischemia may primarily cause a tubular epithelial lesion leaving the hypothalamic-pituitary-gonadal axis intact and allowing normal transformation of gonocytes into spermatogonia. Reduced gonadotropins and ischemia appear to produce distinctly different primary and secondary pathophysiological effects on the testes.
隐睾潜在的损伤可能是激素性的，是促性腺激素缺乏性性腺功能减退的一种短暂围生期不完全形式，其特征是通常在60至90日龄时出现的促性腺激素激增减弱。缺血是与嵌顿性腹股沟疝相关的睾丸潜在损伤。为了确定这两种损伤的组织病理学是否不同，对21个对照睾丸、17个隐睾以及13个与嵌顿性腹股沟疝相关的阴囊内睾丸活检的半薄显微镜切片进行了组织形态计量分析。所有组中的婴儿年龄在30至120日龄之间。结果显示，与之前的研究一样，这个年龄段的隐睾特征为Leydig细胞发育不全、生殖细胞计数正常以及生殖母细胞向成年暗型精原细胞的成熟存在缺陷。相比之下，与嵌顿性腹股沟疝相关的睾丸特征为Leydig细胞增生、生殖细胞计数减少以及生殖母细胞向成年暗型精原细胞的正常成熟。可以得出结论，隐睾的潜在损伤，推测是促性腺激素激增减弱，导致Leydig细胞原发性发育不全和功能减退，进而导致生殖母细胞向精原细胞转化的继发性缺陷。相比之下，缺血可能主要导致肾小管上皮病变，而使下丘脑 - 垂体 - 性腺轴保持完整，并允许生殖母细胞向精原细胞的正常转化。促性腺激素减少和缺血似乎对睾丸产生明显不同的原发性和继发性病理生理效应。
