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Cryptorchidism and Associated Problems in Animals 1 Anim. Reprod., v.3, n.2, p.108-120, April/June. 2006 Cryptorchidism and associated problems in animals 1 R. P. Amann 2 and D. N. R. Veeramachaneni Animal Reproduction and Biotechnology Laboratory Colorado State University, Fort Collins, CO 80523-1683 USA. Abstract Introduction Cryptorchidism is not a single disease; it Cryptorchidism is failure of one or both testes apparently results from failure of one of at least two to be positioned in the scrotum at the time normal for a functions involving products of Leydig cells. species. Typically, cryptorchidism is detected at birth or Cryptorchidism is symptomatic of underlying testis shortly thereafter. Postpubertal abnormalities associated dysgenesis. Precise terminology is important to with cryptorchidism (e.g., testis tumors, atypical distinguish and understand three phases of testis concentrations of reproductive hormones, altered descent. Abdominal translocation involves holding a spermatogenesis in scrotal testis,) are not caused by testis near the internal inguinal ring plus slight elevated temperature of an abdominal location downward migration, via an enlarged gubernaculum (Veeramachaneni, 2006), but as a delayed manifestation (Insl3 obligatory) as the abdominal cavity expands of testis dysgenesis. Such underlying testis dysgenesis away. Concurrently, a cylindrical evagination of of fetal origin might be evident in males who are not peritoneum invades the gubernaculum, cremaster cryptorchid. The concept of a generalized testicular muscle(s) develop within the gubernaculum, and the dysgenesis syndrome (TDS) is considered by Sharpe in cephalic ligament regresses (testosterone not this volume (also Skakkebaek et al ., 1998, 2001; obligatory). Transinguinal migration moves the testis Rajpert-De Meyts, 2006; Sharpe, 2006). through the abdominal wall, via the inguinal canal Early reports on cryptorchidism (e.g., de Graaf, distended by the gubernaculum. Inguinoscrotal 1668) provided evidence of two or more diseases, migration involves subcutaneous movement of because undescended testes are not located at a common gubernaculum, vaginal process, epididymis, and testis to non-scrotal site. Nevertheless, the general perception proper positions in the scrotum. Directional guidance is had been that cryptorchidism is a single disease with provided by chemoattractant calcitonin gene-related moderate heritability, incomplete penetrance, expressed peptide, secreted by the genitofemoral nerve only in males (sex specific expression), and (testosterone dependent). Probably incidence of concentrated by inbreeding or minimized by culling cryptorchidism is higher in companion animals or pigs affected males and all siblings. However, the notion of a than in cattle or sheep. In dogs and horses, a retained single-locus gene problem gave way to acceptance of a testis most commonly is abdominal. In horses, but not polygenic recessive model, based on relatively small other species, retention of testes within the inguinal studies with pigs (Sittmann and Woodhouse, 1977; canal is common. In humans, subcutaneous testes Rothschild et al , 1988) and dogs (Cox et al , 1978; predominate. Overall, cryptorchidism usually is Nielen et al ., 2001); also data for men (Czeizel et al ., unilateral; scrotal testes in unilateral cryptorchid males 1981). It is evident that abnormalities in >20 genes are often produce fewer than normal numbers of sperm, associated with human cryptorchidism (Klonisch et al ., with an increased percentage of abnormal sperm. Non- 2004) and, currently it is accepted that cryptorchidism cryptorchid siblings might manifest similar testicular has many causes including genetic, epigenetic, and dysgenesis. Although risk of tumors is greater for environmental components. cryptorchid males, non-cryptorchid males also develop Terminology testis tumors. Germ cell tumors are most common in dogs and horses. Leydig or Sertoli cell tumors are not unusual in For reasons detailed elsewhere (Amann and dogs. Testis tumors rarely are reported for cattle, pigs, Veeramachaneni, 2007), certain traditional sheep, and rabbits; in cattle Leydig cell tumors are twice as nomenclature does not adequately describe where a common as Sertoli cell tumors. Producers and veterinarians testis was found or when in the process of testis descent should recognize that inadvertent exposure of a the normal process went wrong. Hence, this review pregnant dam to estrogenic or anti-androgenic agents defines and utilizes precise terms and nomenclature could result in testicular dysgenesis. equally applicable to companion, food-producing, or wild animals; rodents or rabbits; and humans. Keywords: cryptorchidism, testis descent, testis Testes are found in one of four general dysgenesis, testis tumors, terminology. locations: abdominal cavity, inguinal canal, __________________________________________________________________ 1Conference paper. International Symposium on Animal Biology of Reproduction, Nov. 15-18, 2006, Belo Horizonte, Brazil. 2Corresponding author: [email protected] Phone: +1 (970)226-0682; Fax: +1(970)226-2340 Amann and Veeramachaneni. Cryptorchidism and testis dysgenesis. subcutaneous, or scrotal. The distinction between positions in the scrotum. inguinal and subcutaneous locations is important. What went wrong during testis descent, in a An abdominal testis is within the abdominal simple sense, can be deduced from observed testis cavity, typically between the kidney and bladder or near location and knowledge of the process. Three terms are the internal inguinal ring. Distinction between proximal needed, but unfortunately and illogically some authors vs near inguinal locations is important because it might have combined the latter two, without differentiation. point to underlying cause. An abdominal testis reflects failure to initiate An inguinal testis is within the space limited by and complete abdominal translocation of the testis, so the internal and external inguinal rings. At least for the testis is not poised near the internal inguinal ring, horses (inguinal canal might be 10 cm long), position but rather near the bladder or part way between the should be precisely defined (Beltran-Brown and inguinal area and kidney. Villegas-Alvarez, 1988). An inguinal testis reflects failure to initiate and A subcutaneous testis usually is found in the complete transinguinal migration of a testis. femoral triangle, but ectopia of the vaginal process A subcutaneous testis reflects failure to initiate might place the testis at some distance or near a and complete inguinoscrotal migration of a cauda malformed scrotum. Unfortunately, imprecision in epididymidis and testis, from outside the inguinal canal defining testis location typifies literature on mice or rats to their final destination in the scrotum. administered an agent which might affect testis descent, In horses, many retained testes are within the and the uninformative “ectopic testis” (i.e., abnormal inguinal canal per se and few are subcutaneous (Cox et location of testis) often is used to describe location of a al ., 1979; Rodgerson and Hansen, 1997), but testes testis not within a normal scrotum or within the which actually are subcutaneous often are classified abdominal cavity. inappropriately as inguinal (Genetzky, 1984). In A scrotal testis is found, and remains, in a humans, however, most undescended testes are scrotum located at the site typical for that species. subcutaneous in the groin, just outside the external However, in rodents and rabbits testes can move in and inguinal ring, or near the neck of the scrotum (Hutson et out from the lower abdominal cavity throughout life, as al ., 1992, 1997). It is imprecise to attribute both the inguinal canal never constricts. Occasionally, a inguinal and subcutaneous testes to failure of scrotal testis might later be retracted permanently into “inguinoscrotal testis descent”; as discussed below, the inguinal canal (retractile testis) or a testis initially different regulating mechanisms likely are involved. deemed to be inguinal or subcutaneous might later be positioned permanently in the scrotum (late descent). Testis descent Such migration is more common in horses, humans, or pigs than in cattle or sheep. To present an overview applicable to common To stipulate discrete phases in the overall species ranging from mice and rabbits to bulls or horses, process of testis descent, three terms are needed since this compilation reinterprets some information in older there are four general locations (see above). The publications. This is done with benefit of recent following terms are descriptive of the process and are information and without discounting underlying useful with any species. observations in classic papers based on many Abdominal translocation of the testis reflects dissections. Literature was cited extensively and what happens during the first phase. At the end of this concepts were discussed in Amann and Veeramachaneni phase, the testis is positioned at the inner inguinal ring (2007), which should be consulted. Here the aim is ease (ready to enter), with the cauda epididymidis just within of comprehension. the inguinal canal. The absolute distance between a Structures involved testis and inguinal area changes little during this phase. Rather, the testes “stay put” as the fetus grows and the The crucial starting point is differentiation of distance between locations of testes and kidneys widens an indifferent gonad to a testis (Rajpert-De Meyts, by slight “downward” relocation to the developing
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