Fetal development of the human gubernaculum with special reference to the fasciae and muscles around it.

Previous descriptions of human gubernacular embryology failed to follow some basic developmental processes, and surgically relevant structures, such as the iliopubic tract, had not been discussed relative to gubernacular development. We addressed these shortcomings in this study that examined two stage-groups of human fetuses. At 8-12 weeks of gestation, the gubernaculum arose from the mesonephric fold at or near the gonad. Gubernacular mesenchyme communicated with the subcutaneous tissue via a narrow slit in the rectus aponeurosis. The inguinal fold, containing the inferior epigastric vessels, was separated from the gubernaculum. At 20-25 weeks of gestation, the gubernaculum connected to the testis or uterus. When the testis successfully descended to a peritoneal recess on the lateral side of the umbilical artery, the gubernaculum connected to the testis free of interference by the thick artery and its associated peritoneal fold. This may explain the known asymmetry in testicular descent. The inguinal canal was enclosed by a sheet-like aponeurosis: its ventromedial part was composed of the rectus sheath and the external oblique aponeurosis, whereas the dorsolateral part consisted of a thick aponeurosis covering or facing the iliopsoas. The former (latter) aponeurosis seemed to develop into the inguinal ligament (the iliopubic tract) in adults. According to the topohistology of the muscles associated with the interfoveolar ligament, we identified muscle fragments around the gubernaculum as derivatives of the transversus and/or internal oblique. Consequently, the inguinal canal contained the cremaster proper developing within the gubernaculum and parts of the abdominal wall muscles mechanically incorporated into the canal.