Bilateral incomplete testicular descent

Many people may not be familiar with the disease of bilateral incomplete testicular descent, but the incidence rate is getting higher and higher. This is because people nowadays do not know how to take care of their bodies, which will aggravate the symptoms. If no treatment is taken, tumor reactions will occur in the testicular area. Once this occurs, appropriate treatment must be taken as soon as possible.

Incomplete testicular descent refers to the descent of the testicles, which stay in the middle of the descent process and fail to enter the scrotum. It is also commonly referred to as cryptorchidism in clinical practice. Cryptorchidism is a congenital disease. The occurrence of cryptorchidism is related to hormone levels, testicular fascia and short spermatic cord. Cryptorchidism often occurs on one side, and the incidence of bilateral cryptorchidism is about 10-25%.

Cryptotestis is often accompanied by inguinal oblique hernia. Cryptotestis that remain in the abdominal cavity or inguinal region are at a higher temperature than the scrotum. If the testicles are in this environment for a long time, they will be underdeveloped and the seminiferous tubules will degenerate, causing spermatogenesis dysfunction. Over time, cryptotestis can degenerate into testicular tumors during puberty. Therefore, cryptotestis should be treated early and retracted into the scrotum to avoid complications. [1]

Anatomical factors

The main ones are: ① Absence of the gubernaculum testis: During the testis descent, the gubernaculum testis has a pulling effect, and the main branch at the end of the gubernaculum is attached to the bottom of the scrotum. The testis descends into the scrotum with the pulling of the gubernaculum. ② The processus vaginalis is not closed. ③ Abnormal development of the inguinal groove: the internal ring is too small or there is mechanical obstruction at the entrance of the scrotum. ④ The spermatic cord blood vessels or vas deferens are too short.

Defective development of the testicles themselves

In some cases, there are defects in the testicles themselves, such as testicles atrophy after twisting in the uterus, with only spermatic cord vessels and vas deferens remnants remaining, testicles separated from epididymis, epididymis absence and other congenital defects affecting testicular descent.

Pathogenesis

Cryptorchidism often has varying degrees of testicular dysplasia, with the size of the healthy side being significantly smaller and the texture being softer. Most patients also have abnormal development of the epididymis and vas deferens, with an incidence of about 19% to 90%. In about 1% to 3% of patients with cryptorchidism, testicles are absent during surgical exploration, and only testicles, epididymal remnants and (or) spermatic cord vessels, and vas deferens remnants are seen.

The pathological histological features of cryptorchidism are reproductive cell development disorders and a decrease in the number of interstitial cells. The changes become more obvious with age. The seminiferous tubules of adult cryptorchidism undergo significant degeneration and normal sperm are almost invisible. These changes are also related to the location of the cryptorchidism. The lower the location and the closer to the scrotum, the milder the pathological damage. Conversely, the higher the location, the more severe the pathological damage.