Descent of the Testis

Part 1 Evolution of descent of the testis and early history of research: evolution of testicular descent; early work on testicular descent. Part 2 Transabdominal migration of the testis: the first hase of descent; the gubernacular swelling reaction; oestrogen-treated mouse; persistent mullerian duct syndrome; the role of mullerian inhibiting substance (MIS); conclusion. Part 3 Inguinoscrotal descent of the testis: migration of the gubernaculum; intra-abdominal pressure; the role of testosterone; the genitofemoral nerve hypothesis; sexual dimorphism of the genitofemoral nerve; the effect of CGRP; conclusion. Part 4 Classification and causes of undescended testes in humans: classification of undescended testes; the incidence of undescended testis; what causes cryptorchidism?; cryptorchidism in rare syndromes. Part 5 The postnatal effects of cryptorchidism: a primary anomaly or secondary effects?; endocrine effects; morphological effects; fertility; malignancy. Part 6 Diagnosis of undescended testis: introduction; aims of clinical examination; technique of examination; undescended testis versus retractile testis; clinical features of ectopic testes; impalpable testis; conclusion. Part 7 Operative treatment: planning surgery; the standard orchidopexy; unusual findings during orchidopexy; spermatic cord of inadequate length; the unilateral impalpable testis; surgical management in the post-pubertal child; indications for orchidectomy; complications. Part 8 Hormonal treatment: historical background; rationale for treatment; standard regimes; does hormonal treatment work?; possible benefits of hormonal treatment; why hormonal treatment fails; conclusions. Part 9 Results of treatment: criteria of assessment; cosmetic result; fertility; malignancy; conclusions. Part 10 Conclusions and future developments.