Acer Tuğba, Hiçsönmez Akgün
Department of Pediatric Surgery, Başkent University Faculty of Medicine, 6. cad. No:70/1 Bahçelievler, Ankara, Turkey,
Pediatr Surg Int. 2014 Nov;30(11):1155-61. doi: 10.1007/s00383-014-3596-5. Epub 2014 Sep 14.
Epididymal anomalies are common in cryptorchid patients. This led us to consider that anomalies of the epididymis, to which the gubernaculum is attached, or abnormal attachment of the cranial end of the gubernaculum, could lead to cryptorchidism.
Twenty-eight male Sprague-Dawley rats were divided into two groups: In Group 1 rats (n = 14), the epididymis was isolated from the testis, and in Group 2 rats (n = 14), the gubernaculum was isolated from the epididymis and re-attached to the tail of the epididymis. In both groups, the non-operated testes were used as the control.
In Group 1, cryptorchidism rates were 1/14 in the control testes and 8/14 in the operated testes (p < 0.01). In Group 2, cryptorchidism rates were 0/13 in the control testes and 6/13 in the operated testes (p < 0.01).
Cryptorchidism was seen when the epididymis was loosely or non-connected to the testis and the gubernaculum was attached solely to the epididymis (mimicking anomalies of ductal fusion) and when the gubernaculum was attached to the tail of the epididymis (mimicking anomalies of ductal suspension). Therefore epididymal anomalies and abnormal attachment of the gubernaculum may play a role in the undescendence of the testes in the rats.
附睾异常在隐睾患者中很常见。这使我们认为,与睾丸引带相连的附睾异常,或睾丸引带头端的异常附着,可能导致隐睾症。
将28只雄性Sprague-Dawley大鼠分为两组:在第1组大鼠(n = 14)中,将附睾与睾丸分离,在第2组大鼠(n = 14)中,将睾丸引带从附睾分离并重新附着于附睾尾部。在两组中,未手术的睾丸用作对照。
在第1组中,对照睾丸的隐睾率为1/14,手术睾丸的隐睾率为8/14(p < 0.01)。在第2组中,对照睾丸的隐睾率为0/13,手术睾丸的隐睾率为6/(p < 0.01)。
当附睾与睾丸疏松连接或不连接且睾丸引带仅附着于附睾时(模拟导管融合异常),以及当睾丸引带附着于附睾尾部时(模拟导管悬吊异常),会出现隐睾症。因此,附睾异常和睾丸引带的异常附着可能在大鼠睾丸下降不全中起作用。