Gubernaculum and Epididymo-Testicular Descent: Review of the Literature
Review papers
Eleonora Ivanova
Vilnius University, Faculty of Medicine, Lithuania
Beata Vincel
Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
Gilvydas Verkauskas
Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
Faruk Hadziselimovic
Institute for Cryptorchidism Research, Kindermedizinisches Zentrum, Liestal, Switzerland
Published 2022-07-25
https://doi.org/10.15388/Amed.2022.29.2.6
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Keywords

cryptorchidism
epididymo-testicular descent
gubernaculum
Insl3

How to Cite

1.
Ivanova E, Vincel B, Verkauskas G, Hadziselimovic F. Gubernaculum and Epididymo-Testicular Descent: Review of the Literature. AML [Internet]. 2022 Jul. 25 [cited 2024 Nov. 21];29(2):177–186. Available from: https://journals.vu.lt./AML/article/view/26807

Abstract

Cryptorchidism is a common disorder in boys that has been widely studied both experimentally and clinically. The role of the gubernaculum, a mesenchymal tissue extending from the fetal testis and epididymis to the developing scrotum, is still unclear. Even the name is debated: ‘gubernaculum epididymis’ or ‘gubernaculum testis’. This review does not aim to provide a global overview of competing theories on testicular descent, but focuses on the role of the gubernaculum in epididymo-testicular descent. We identified four major pitfalls of gubernaculum research: the role of the gubernaculum, of insulin-like peptide 3, anti-Müllerian hormone, and androgens. The major critical issues were that the gubernaculum plays a guiding role for the epididymis, descending prior to the testis and expanding the inguinal canal; insulin-like peptide 3 is not as important for the process of descent in humans as the rate of insulin-like peptide 3 mutations is low; anti-Müllerian hormone plays no significant role in epididymo-testicular descent; androgens and gonadotropins play a crucial role in epididymo-testicular descent. The role of the epididymis in the complex process of gubernaculum, epididymis, and testis migration is underestimated and should be included in future research.

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