الفهرس 
Embryology of the male genital systemOnly 14 pages are availabe for public view
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Abstract
The present study was carried out on 11 patients with cryptorchidism,
their ages ranged from 1.5 to 24 years. All patients were presented in urology
department Benha university hospital. They were presented with unilateral
crytorchidism.
Preoperative assessment for all patients were done including complete
history, general and local examinations, laboratory, and ultrasound scanning.
Laparoscopy was performed for one case with non palpable testis which was
not detected by ultrasonography.
Intra-operative assessment was done including location of the testes
which were mostly conalicular besides presence patent process vaginalis and
extrascrotal attachment of the gubernaculum in most of the cases.
During orchiopexy, a biopsy, 3mm diameter was taken for study by light
and electron microscope.
For light microscope the specimens were stained by toulidine blue,
Masson’s trichrome for structure and morphometeric study.
For transmission electron microscope the specimens were examined for
ultrastructural changes.
The patients were divided into three groups according to the age; group I
early childhood (first two years of life), group II. Prepubertal (11-12 years of
life) and group III postpubertal (24 years).
Histopathologic findings of cryptorchidism in the present study were
compared with normally descended testes reported in the literatures.
By light microscope:
In group I; there were no marked structural difference between the
cryptorchid and normally descended testes.
Summary and Conclusions ( )
145
In group II; progressive changes were noted. The seminiferous tubules
were distored and the basement membrane became thickened. The interstitium
showed increased connective tissue cells.
In group III; there were marked structural changes besides strongly
vacuolated germinal tissue with Sertoli cell only remaining. The basement
membrane were markedly thick and irregular. The interstitium contains
connective tissue cells.
Morphometric study: the tubular diameter showed values near to normal
one in group I in comparison to normally descended testes, while in group II
and group III, these values diminshed markedly. Also, the mean
spermatogonial count/tubule was nearly normal, while it was lower in-group II
in comparison to normally descended testes. In post pubertal group the tubules
were deviod of spermatogonia and they were lined by Sertoli cells only.
Carcinomma in situ (CIS) was not detected in any case in the present
study. This might be due to the small number of cases.
By transmission electron microscope:
In group I; Early changes were noted which were not detected by light
microscope, there were occasional defective tubular epithelial cells and few
cytoplasmic organelles. Early fibrosis of the interstitium was noted by electron
microscope by age of 1.5 years appearing as collagen fibres oriented in different
direction besides ill developed Leydig cells.
In group II; more progressive changes were seen. There were
fragmentations of the cytoplasm of spermatogonia with increased vacuolations.
Mitochondria were seen ruptured in some of them besides increased numbers of
free ribosomes which represent the histological character in this group. Also,
marked plications of Sertoli cells were seen with vacuolic degenerations besides
Summary and Conclusions ( )
146
heterogenous pattern of chromation. Collagen fibres were increased in the
interstitum besides maldeveloped Leydig cells.
In group III; massive degenerative changes of germinal epithelium were
seen. The tubules were populated by Sertoli cells only. The intertestisum was
merkedly collagenized and the regressive Leydig cells were present.
We concluded according to the present study that:
1.With advacing the age of cryptorchidism, the changes in the testes are
becoming more and more.
2. Testicular biopsy during orchiopexy is necessary for histological study.
3. By electron microscope, the testicular changes could be detected earlier
than that by light microscope.
4. Orchiopexy is preferred to be done before the age 1.5 years.