PTU - Polskie Towarzystwo Urologiczne
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Article published in Urologia Polska 1999/52/4.


Przemysław Przewratil, Józef Kobos, Jerzy Niedzielski
Klinika Chirurgii i Onkologii Dziecięcej IP AM w Łodzi
Kierownik: dr n. med. J. Niedzielski
Pracownia Patomorfologii Instytutu Pediatrii AM w Łodzi
Kierownik: dr hab. med. J. Kobos


testis cryptorchidism estrogen and progesteron receptors


Cryptorchidism is the serious developmental disorder which point is stop
the testis on its way of descent to the scrotum. 2-8% of all male newborns are
afected with this defect. It re±uires early hormonal therapy or/and surgery.
Mechanism of maldescent is still not well recognized. There are two probable
pathologic mechanisms: anatomical and hormonal. Second one is based on
disruptions in the hypothalamus-pituyitary-testis axis. There are many data
on the role of androgens in testicular descent but the role of estrogens in this
process is not well known. The aim of this study is to explain the role of estrogens
and progesteron and their tissular receptors in pathogenesis of cryptorchidism.
Material and method. 19 patients (48 specimens) with unilateral crypto-
rchidism, aged from 2 to 8 years were analysed. In all cases during the orchi-
dopexy, specimens of gubernaculum, cremaster muscle and processus vaginalis
were taken. 17 boys (25 specimens), aged from 1 to 6 years, operated on due
to inquinal hernia, with testes in scrotum formed control group. Histo-
pathological specimens normaly prepared were stained with hematoxyline
and eosine (H+E) and tested immunohistochemicaly in LSAB detecting system,
according to immunoperoxidase method. Monoclonal mice antybody against
Estrogen Receptor (ER) and Progesterone Receptor (PR) was used. Histo-
pathological structure and then receptor immunoreactivity was assessed in
each specimen.
Results. Cryptorchid group - ER was detected in 9 (fraction 0.6) cases
and PR in 7 (fraction 0.47) cases of 15 gubernaculum specimens. ER was detected
in 18 (fraction 0.95) cases and PR in 14 (fraction 0.74) cases of 19 cremaster
specimens. ER was detected in 11 (fraction 0.79) cases and PR in 6 (fraction
0.43) of 14 processus vaginalis specimens. Control group - ER and PR were not
detected in any of 10 cremaster specimens. ER was found only in 2 (fraction
0.13) cases and PR in 1 cases (fraction 0.07) of 15 processus vaginalis specimens.
In both cases there were single cells with receptor immunoreactivity. According
to these results it is clear that estrogen and progesteron receptors are present
in most cases in cremaster and processus vaginalis of cryptorchid children. In
control group this expression was not found. In gubernaculum hormonal
receptors are also present but in lesser degree.
Conclusion. Except of androgen effect there is probable significant
correlation between disruptions in estrogen regulation, expressed in tissues
receptors, and testicular maldescent. Obtained results can be a proof of fetal
exposition to estrogens in tested patients.


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