The first half of this review examines the boundary between endocrinology and embryonic development with the aim of highlighting the way hormones and signalling systems regulate the complex morphological changes to enable the intraabdominal fetal testes to reach the scrotum.
The genitofemoral ligament, or gubernaculum first enlarges to hold the testis near the groin, and then it develops limb-bud-like properties and migrates across the pubic region to reach the scrotum. Recent advances show key roles for insulin-like-hormone 3 (INSL3) in the first step, with androgen and the genitofemoral nerve involved in the second step. The mammary line may also be involved in initiating the migration.The key events in early postnatal germ cell development are then reviewed, as there is mounting evidence for this to be crucial in preventing infertility and malignancy later in life. We review the recent advances in what is known about aetiology of cryptorchidism, and summarise the syndromes where a specific molecular cause has been found. Finally we cover the recent literature on timing of surgery, the issues around acquired cryptorchidism and the limited role of hormone therapy. We conclude with some observations about the differences between animal models and baby boys with cryptorchidism.
Written by:
Hutson JM, Southwell BR, Li R, Lie G, Ismail K, Harisis G, Chen N. Are you the author?
F Douglas Stephens Research Group, Murdoch Childrens Research Institute, Melbourne; Urology Department, Royal Children's Hospital, Melbourne; Department of Paediatrics, University of Melbourne.
Reference: Endocr Rev. 2013 May 10. Epub ahead of print.
doi: 10.1210/er.2012-1089
PubMed Abstract
PMID: 23666148
UroToday.com Pediatric Urology Section
