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Anatomical and Functional Aspects of Testicular Descent and Cryptorchidism¹

F. Douglas Stephens Surgical Laboratory, Royal Children’s Hospital Research Foundation, and Department of Paediatrics, University of Melbourne Urology Department, Parkville, Victoria, Australia (J.M.H., S.H.); and Tygerberg Hospital and Faculty of Medicine, University of Stellenbosch, South Africa (C.F.H.)

I. Normal Development

A. Anatomical aspects

1. Sexual development

2. The gubernaculum

3. Cranial suspensory ligament

4. Abdominal pressure

B. Hormonal control and functional aspects of testicular descent

1. Müllerian inhibiting substance

2. Androgen

3. The genitofemoral nerve (GFN)

4. Calcitonin gene-related peptide (CGRP)

II. Cryptorchidism

A. Etiology

B. Frequency

C. Are some UDT acquired?

D. Risks of infertility/malignancy

E. Role of hormone therapy

F. Timing of surgery