title: The area and attachment abnormalities of the gubernaculum in patients with undescended testes in comparison with those with retractile testes.
abstract: OBJECTIVE
  In order to evaluate the gubernaculum (GN) abnormalities quantitatively in patients with undescended testes (UDT), the area and attachment site of the gubernaculum were evaluated.
  
  
  METHODS
  Sixty-seven testes from 61 patients with an undescended testis treated in the past 11 years at our institution were examined. Using intraoperative photographs or DVDs, the area of the GN inside the processus vaginalis was measured, and the ratio to that of the testis was determined. When the GN was attached to the vas deferens, the GN distance from the testis was also measured, and the ratio to that of the transverse length of the testis (deviation index) was calculated. Reference values were obtained from 23 testes from 15 patients with mobile testes.
  
  
  RESULTS
  In cases with mobile testes, the GN attached to the bottom of the testis, and involved the lower pole of the epididymis. Even though the GN was attached to the bottom of the testis in 43 testes in the UDT patients (64 %), the GN was found to be elongated. The mean GN area ratio was 1.58 (1SD, 0.6) in the UDT cases, in comparison to 0.47 (0.2) in the cases with mobile testes. The GN was attached to the vas deferens in 24 testes (36 %). The deviation index was 1.34 (1.0), but the GN area ratio of these cases was 1.56 (0.7), which was similar to that of the GN attached to the bottom of the testis.
  
  
  CONCLUSIONS
  The present study revealed that an increase in the GN area ratio was the most common imaging abnormality in cases with UDT.
authors.affiliation: Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan, mkubota@med.niigata-u.ac.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kubota
authors.forename: Kengo
authors.initials: K
authors.lastname: Nakaya
authors.forename: Yuhki
authors.initials: Y
authors.lastname: Arai
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ohyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Yokota
authors.forename: Yu
authors.initials: Y
authors.lastname: Nagai
mesh_terms: D001837:Body Weights and Measures / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D007264:Inguinal Canal; D008297:Male; D013733:Testicular Diseases / Q000473:pathology* / Q000601:surgery; D013737:Testis / Q000002:abnormalities* / Q000473:pathology* / Q000601:surgery; D014649:Vas Deferens