RESUMO
BACKGROUND: There are no reports comparing testicular volume between normal fetuses, fetuses with prune-belly syndrome (PBS), and fetuses with anencephaly. The study hypothesis was that PBS and especially anencephaly alter the testicular volume during the human fetal period. AIM: The objective of the study was to compare the testicular growth in fetuses with anencephaly, with PBS, and without anomalies. STUDY DESIGN: This is a morphometric study of human fetuses. Seventy testes from fetuses without anomalies aged 11-22 weeks post-conception (WPC), 30 testes from fetuses with anencephaly aged 13-19 WPC, and eight testes from fetuses with PBS aged 13-16 WPC were studied. Testicular length, width, and thickness were evaluated with the aid of computer programs (Image Pro and ImageJ) (Figure). The fetal testicular volume was calculated using the ellipsoid formula: Testicular volume (TV) = [length × thickness × width] × 0.523. The Shapiro-Wilk test was used to ascertain the normality of the data and to compare quantitative data between normal fetuses vs. fetuses with anencephaly, while the Kruskal-Wallis test was used to assess gender and laterality differences. Simple linear correlations (LCs) were calculated for testicular volume according to fetal age, weight, and crown-rump length. RESULTS: All 108 testes studied were abdominal. The right (p = 0.0310) and left (0.0470) testicular volumes were significantly smaller in fetuses with anencephaly than those in the control group. The linear regression analysis indicated that the right and the left testis volume in the control group (right: r2 = 0.6665; left: r2 = 0.6707) and PBS group (right: r2 = 0.9937; left: r2 = 0.9757) increased with fetal age (p < 0.0001). This analysis also indicated that the testicular volume in fetuses with anencephaly did not increase with fetal age (right: r2 = 009816; left: r2 = 0.07643). DISCUSSION: This article is the first to report testicular volume correlations with fetal parameters in fetuses with anencephalic and fetuses with PBS. Significant alterations were observed in testicular growth in the anencephalic group compared with the control group, and it was also observed that the bilateral cryptorchidism in PBS does not alter the testicular development and growth during the fetal period. The unequal WPC distribution between fetuses with PBS, fetuses with anencephaly, and controls and the small sample size are limitations of this study. Further studies should be performed to confirm this study's findings. CONCLUSIONS: Testicular growth is slower and does not show significant correlations with fetal parameters in fetuses with anencephalic. Significant differences in testicular development in fetuses with PBS was not observed.
Assuntos
Feto/diagnóstico por imagem , Síndrome do Abdome em Ameixa Seca/diagnóstico , Testículo/embriologia , Idade Gestacional , Humanos , Masculino , Tamanho do Órgão , Síndrome do Abdome em Ameixa Seca/embriologia , Testículo/crescimento & desenvolvimentoRESUMO
PURPOSE: We compared and contrasted the structure of the gubernaculum testis in fetuses with prune belly syndrome and normal controls. MATERIALS AND METHODS: We studied a total of 6 gubernacula from 3 male fetuses with prune belly syndrome and a total of 14 from 7 male fetuses without an anomaly. Gubernacular specimens were cut into 5 µm sections and stained with Masson trichrome to quantify connective tissue and smooth muscle cells, with Weigert stain to observe elastic fibers and with picrosirius red with polarization to observe collagen. Immunohistochemical analysis was done with tubulin to observe the nerves. Images were captured with a BX51 microscope and DP70 camera (Olympus®). Stereological analysis was done with Image-Pro and ImageJ (MediaCybernetics®) using a grid to determine volumetric density. Means were statistically compared with the Mann-Whitney test. All tests were 2-sided with p <0.05 considered statistically significant. RESULTS: Prune belly syndrome fetuses were at 17 to 31 weeks of gestation and control fetuses were at 12 to 35 weeks of gestation. Quantitative analysis showed no difference in the volumetric density of smooth muscle cells in prune belly syndrome vs control gubernacula (mean 15.70% vs 19%, p = 0.2321). Collagen fiber analysis revealed a predominance of green areas in prune belly syndrome gubernacula, suggesting collagen type III, and a predominance of red areas in control gubernacula, suggesting collagen type I. Elastic fibers were significantly smaller in prune belly syndrome gubernacula than in control gubernacula (mean 14.06% vs 24.6%, p = 0.0190). Quantitative analysis demonstrated no difference in the volumetric density of nerves in prune belly syndrome or control gubernacula (mean 5.200% vs 3.158%, p = 0.2302). CONCLUSIONS: The gubernaculum in fetuses with prune belly syndrome had altered concentrations of collagen and elastic fibers. These structural alterations could be one of the factors involved in cryptorchidism in prune belly syndrome.
Assuntos
Criptorquidismo/embriologia , Doenças Fetais/patologia , Feto/embriologia , Síndrome do Abdome em Ameixa Seca/embriologia , Testículo/embriologia , Colágeno/metabolismo , Tecido Conjuntivo/embriologia , Estatura Cabeça-Cóccix , Criptorquidismo/metabolismo , Tecido Elástico/embriologia , Tecido Elástico/metabolismo , Doenças Fetais/metabolismo , Humanos , Imuno-Histoquímica , Masculino , Miócitos de Músculo Liso/metabolismo , Síndrome do Abdome em Ameixa Seca/metabolismo , Escroto/embriologia , Testículo/metabolismoRESUMO
Os autores apresentam um caso da Síndrome de Prune Belly ou "abdome em ameixa". A síndrome é caracterizada por agenesia ou deficiência congênita da musculatura da parede anterior do abdome, associada a criptorquidia bilateral e malformaçöes do sistema coletor do trato urinário. Os aspectos clínicos típicos foram facilmente identificados após o nascimento. Os achados da acentuaçäo da lordose lombossacral e da chamada "muesca en rodilla" conferem maior destaque ao caso apresentado.
Assuntos
Recém-Nascido , Humanos , Masculino , Feminino , Gravidez , Adulto , Doenças do Recém-Nascido/tratamento farmacológico , Lordose , Músculos Abdominais/anormalidades , Região Lombossacral , Síndrome do Abdome em Ameixa Seca/embriologia , Síndrome do Abdome em Ameixa Seca , Coluna Vertebral , Amicacina/uso terapêutico , Ceftriaxona/uso terapêutico , Cefalexina/uso terapêutico , Infecções por Enterobacteriaceae , Infecções por Escherichia coli , Feto/anormalidades , Imipenem/uso terapêutico , Infecções por Klebsiella , Infecções por Pseudomonas , Sistema Urinário/anormalidadesRESUMO
El "Síndrome de Prune Belly" es una enfermedad rara y complicada, que afecta a órganos genitourinarios y pared abdominal, se le da este nombre por el aspecto del abdomen después de drenar la vejiga, en su forma totalmente desarrollada se presenta con la tríada: megaloquiste, deficiencia muscular abdominal y criptorquidia. Se presenta un caso de 22 semanas de gestación con diagnóstico por ultrasonografía de un gran quiste toracoabdominal. Se revisó la literatura