Ultrastructural deficiency in autonomic innervation in cremasteric muscle of boys with undescended testis.
OBJECTIVE
The cremaster muscles (CM) associated with undescended testis reveal neurogenic alterations that mainly affect type 2 fibers. The ultrastructure of CM has been evaluated to define if further evidence to explain the alterations could be identified.


METHODS
CM of 8 boys with inguinal hernia and 8 boys with undescended testis at similar ages were biopsied. Samples were processed for electron microscopic evaluations. Semithin and thin sections were examined under an electron microscope.


RESULTS
The CM associated with inguinal hernia showed normal ultrastructure. However, some alterations were encountered in CM associated with undescended testis. Unmyelinated fibers were diminished in number, and myelinated fibers were outnumbering the unmyelinated fibers. Marked disorientation of myofibers, redundant sarcolemma, empty sleeves of basal lamina, disarray of myofibrils, densely packed myofilaments, Z disk streaming, dilated sarcoplasmic reticulum, and dense-irregularly shaped mitochondria were repeatedly encountered. Satellite cells appeared inactive. Most of the fibers were contracted.


CONCLUSIONS
The decrease in number of unmyelinated fibers appears to represent a decrease in autonomic nerve fibers. The alterations within muscle fibers may reflect a deficiency in autonomic innervation. Autonomic nervous system is highly responsive to circulating androgens. Factors decreasing the vulnerability of autonomic nervous system against androgenic effects may result in a CM with neurogenic alterations, thus inhibiting testicular descent. J Pediatr Surg 36:573-578.
Department of Pediatric Surgery, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey.
F C
FC
Tanyel
S
S
Müftüoğlu
A
A
Dağdeviren
L
L
Karakoç
N
N
Büyükpamukçu
D000009:Abdominal Muscles / Q000294:innervation* / Q000648:ultrastructure*; D000728:Androgens / Q000096:biosynthesis; D001341:Autonomic Nervous System / Q000648:ultrastructure*; D001707:Biopsy, Needle; D002675:Child, Preschool; D003456:Cryptorchidism / Q000473:pathology*; D046508:Culture Techniques; D006552:Hernia, Inguinal / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D008854:Microscopy, Electron; D018485:Muscle Fibers, Skeletal / Q000648:ultrastructure; D009412:Nerve Fibers / Q000648:ultrastructure; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D000728:Androgens