Testicular proximity can induce gubernaculum formation after delivery

Abstract

Purpose: This paper presents the hypothesis that after delivery as late as 38 weeks' gestation, a testis placed near the internal ring can induce the formation of a gubernaculum and undergo a belated but otherwise normal descent.

Methods: Two boys with a gastroschisis were each born with one of their testes prolapsed through the defect. The testis was sutured just lateral to the deep inferior epigastric vessels at the time of the primary closure of the gastroschisis.

Results: One boy born at 34 weeks had his left testis prolapsed through a left-sided gastroschisis defect. At 3 months, he was admitted to the hospital with a large left inguinal hernia. The repair was complicated by the presence of a large mass of jellylike tissue extending through the internal ring to the upper scrotum. A second boy was born at 38 weeks' gestation. The testis made its way uneventfully into the right hemiscrotum by 10 months of age.

Conclusion: These cases suggest that testicular proximity is a critical factor in the formation of the gubernaculum and that the testis can induce the formation of the gubernaculum as late as 38 weeks gestation.