Mythical 'Tails of Lockwood'.

The cause of testicular ectopia has long been a mystery, and over the years, many hypotheses have been suggested to explain the condition. The most famous of these hypotheses is that of the 'Tails of Lockwood'. This developed from a paper written in 1888 by Charles Barrett Lockwood. Although little evidence has ever been found to corroborate this hypothesis, it remains in many textbooks and journal articles to the present day. In the 21st century, this theory should no longer be given as the cause for ectopic testes. Current biological evidence supports a complex process of growth, by elongation and migration of the gubernaculum, rather than a simple mechanical process of testicular descent, as proposed in the 18th century.

Thomas Annandale and the first report of successful orchiopexy.

PURPOSE: We investigate the surgeon and factors behind the first report of successful orchiopexy. MATERIALS AND METHODS: We reviewed the first reports of orchiopexy, and the work and writings concerning Thomas Annandale and the time in which he practiced. RESULTS: Annandale was a surgeon in Edinburgh, Scotland, in the late 19th century. In 1877 he successfully brought down an ectopic testicle in a 3-year-old boy. This first reported successful orchiopexy was due in large part to Lister's antiseptic technique. CONCLUSIONS: Annandale performed the first successful orchiopexy by integrating the surgical and antiseptic ideas of his predecessors and contemporaries.

Criptorquia / Cryptorchism

Os testículos situados fora do escroto, até hoje, não têm uma nomenclatura exata é aceita unanememente. São designados como criptorquia, criptorquidia, testículos retidos, não descidos, migratórios, retráteis, flutuantes, ectópicos. Estão anotados na história do homem desde o quarto séc. aC, quando eram condições compatíveis com os eunucos e homossexuais. Na Renascença, sobretudo italiana, adquiriram grande importância para a escolha dos modelos masculinos usados na escultura e na pintura da época. Somente em 1820, com a primeira orquiopexia de Rosenmeckel, são vistos e tratados cientificamente pela Medicina. Entretanto, ainda não é reconhecida uma etiopatogenia bem definida, entre seus fatores genéticos, hormonais ou anatômicos. Também não está acertada a idade terapêutica, principalmente a cirúrgica. A hormonioterapia continua duvidosa e de resultados muito questionáveis. As técnicas e táticas operatórias do abaixamento testicular são diversas e variadas, com resultados discutíveis. A videolaparoscopia é muito recente para ser avaliada. A microscopia ótica e a eletrônica têm trazido dados histopatológicos mais objetivos e definidores da idade cirúrgica ideal e das operações de melhores resultados. Em verdade, o assunto permanece em aberto. Depois que fomos alertados pelo Professor Pedro Salles, cuja aposentadoria não lhe apagou os méritos e a perspicácia, desde 1956, os testículos cripticos se constituíram em nossa principal linha de pesquisa e do nosso grupo de trabalho. Sobre muitos pontos firmamos uma opinião e uma conduta que esperam pelo julgamento do tempo. Mas ainda há muito para ser esclarecido.

There is no precise and unanimously accepted nomenclature for out of scrotum located testicles. Crystorchidism and retained, non-descending, migratory, retractile, fluctuating and ectopic testicles are current designations for the phenomenon. Since the fourth century B.C., this condition has been described among eunuchs and homosexuals. In Renaissance, especially in Italy, cryptorchid men were chosen as models in painting and sculpture. Only in 1820, with the first orchiopexy performed by Rosenmeckel, cryptorchid patients were scientifically treated. However, among the genetic, hormonal, and anatomic factors, the precise etiopathogeny of this condition is ill defined. Also, the proper age for intervention, mainly the surgical one, is not precise. The hormone therapy is controversial and the results are questionable. There are many techniques for surgical intervention, aiming the descending of the testicles with questionable results. The videolaparoscopic technique is very recent to be properly evaluated. The optical and electronic microscopy have brought more objective data to define the ideal surgical procedure for optimal results. In fact, the problem is still open. Since 1956, when Prof. Pedro Salles called the attention of the authors on cryptic testicles, this matter has been the main line of research of this group. The procedures have been followed over four decades. Time will tell whether of not they are correct. The subject has not been settled yet. Much research is needed on this subject.

[Bernhard Schapiro (1888-1966): Talmudic scholar - andrologist - pioneer of hormonal treatment for cryptorchidism]. / Bernhard Schapiro (1888-1966): Talmudgelehrter - arzt - wegbereiter der hormonbehandlung des kryptorchismus.

Bernhard Schapiro was the first to recommend anterior pituitary lobe hormone for the treatment of cryptorchidism. He was born in 1888 into an orthodox family in Dvinsk (Daugavplis/Latvia), in the Pale of Settlements for Jewish Russian subjects. In simple schools he learned Hewbrew and basics of Torah and Talmud. Then he turned to the Talmudic Academy "Slobodka" in Kovno (Kaunas/Lithuania) for advanced studies. Here he internalized the "Musar" teachings, a doctrine of high-standard ethical behavior towards fellow beings, until he was eighteen. He abandoned a rabbincal carrer and studied medicine in Switzerland. After exams in 1919, he received a training in dermatology with JADASSOHN in Breslau. From 1922 until 1933 he worked at HIRSCHFELD's Institute for Sexual Science in Berlin. Here he pioneered in andrology working on the problems of impotency and premature ejaculation and developing new drug combinations. In males with underdeveloped genitalia he proved the cryptorch testicles may descend under treatment with anterior pituitary lobe. After Nazi students had looted the Institute in May, 1933 he left Germany with wife and four children and established a practice in Zurich. He chaired the Swiss branch of Mizrakhi, which aimed at influencing Zionism with orthodox spirituality. In 1940 he turned to New York where even rabbis recommended his treatment as in accordance with talmudic laws. From 1951 until his death in 1966 he lived and worked on the same issues in Jerusalem. His entire life was guided by Musar.

Criptorquia / Cryptorchism

Os testículos situados fora do escroto, até hoje, não têm uma nomenclatura exata é aceita unanemente. São designados como criptorquia, criptorquidia, testículos retidos, não descidos, migratórios, retráteis, flutuantes, ectópicos. Estão anotados na história do homem desde o quarto séc. aC, quando eram condições compatíveis com os eunucos e homossexuais. Na Renascença, sobretudo italiana, adquiriram grande importância para a escolha dos modelos masculinos usados na escultura e na pintura da época. Somente em 1820, com a primeira orquiopexia de Rosenmeckel, são vistos e tratados cientificamente pela Medicina. Entretanto, ainda não é reconhecida uma etiopatogenia bem definida, entre seus fatores genéticos, hormonais ou anatômicos. Também não está acertada a idade terapêutica, principalmente a cirúrgica. A hormonioterapia continua duvidosa e de resultados muito questionáveis. As técnicas e táticas operatórias do abaixamento testicular são diversas e variadas, com resultados discutíveis. A videolaparoscopia é muito recente para ser avaliada. A microscopia ótica e a eletrônica têm trazido dados histopatológicos mais objetivos e definidores da idade cirúrgica ideal e das operações de melhores resultados. Em verdade, o assunto permanece em aberto. Depois que fomos alertados pelo Professor Pedro Salles, os testículos crípticos se constituíram em nossa principal linha de pesquisa e do nosso grupo de trabalho. Sobre muitos pontos firmamos uma opinião e uma conduta que esperam pelo julgamento do tempo. (AU)

[Historical development of the surgical treatment of the undescended testicle]. / Die historische Entwicklung der operativen Behandlung des Maldescensus testis.

An undescended testicle can be found in about 3-4% of all newborns and in 21-23% of all premature infants. In most of the young patients, the testicle will descend spontaneously during the first year of life. Thus, at the end of the second year of life, an undescended position of the testis will remain in 1-2% of all children. Since the first successful surgical treatment of the undescended testicle by Max Schüller 120 years ago in Munich, many various surgical procedures have been described. This paper gives an overview starting with the historical development of the operative treatment of the undescended testicle and leading up to the modern techniques used today.

Reed Nesbit and pediatric urology.

OBJECTIVES: To ascertain the pediatric urology experience and contributions of Reed Nesbit, a urologist known primarily as an educator, transurethral resectionist, and prostate expert. METHODS: The writings of Nesbit and appropriate background references were analyzed. RESULTS: Nesbit's contributions to pediatric urology, particularly the Cabot-Nesbit orchidopexy, the buttonhole preputial transposition, the dorsal tunical tuck for chordee, and the elliptical anastomosis were significant. CONCLUSIONS: Nesbit's contributions to pediatric urology were innovative and enduring.