Cranial attachment of the gubernaculum associated with undescended testes

Elongated epididymis is an abnormality encountered most frequently in patients who have an undescended testis (or testes). To clarify the implication of this anomaly in testicular descent, the anatomic configuration of paratesticular structures, especially the site of cranial attachment of the gubernaculum in relation to the configuration of the vas deferens, was evaluated in 54 undescended testes of 44 patients. Undescended testes were associated with an elongated epididymis in 42.5% of cases. Of these, the cranial gubernaculum was attached solely to the vas deferens in 73.9%. In this group, the cranial gubernaculum was attached to the most descended part of the loop of the vas deferens. No patient with a nonelongated epididymis had a gubernaculum attached solely to the vas deferens. These results suggest that the abnormal attachment of the cranial gubernaculum in the embryological stage might affect the mode of descent of adjacent paratesticular structures. (C) 1996 by W.B. Saunders Company