Do prune belly syndrome and neural tube defects change testicular growth? a study in human fetuses

Summary BACKGROUND There are no reports comparing testicular volume between normal, prune belly syndrome (PBS) and anencephalic fetuses. Our 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, PBS and without anomalies. STUDY DESIGN This is a morphometric study of human fetuses. We studied 70 testes from fetuses without anomalies, aged 11-22 weeks post-conception (WPC); 30 testes from anencephalic fetuses, aged 13-19 WPC; and eight testes from PBS fetuses, aged 13-16 WPC. We evaluated testicular length, width and thickness with the aid of computer programs (Image Pro and Image J) (FIGURE). The fetal testicular volume was calculated using the ellipsoid formula: Testicular volume (TV) = [length x thickness x width] x 0.523. The Shapiro-Wilk test was employed to ascertain the normality of the data and to compare quantitative data between normal vs. anencephalic fetuses, while the Kruskal-Wallis test was used to assess gender and laterality differences. Simple linear correlations (LC) 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 anencephalic fetuses compared to the control group. The linear regression analysis indicated that the right and the left testis volume in the control group (Right: r 2 = 0.6665; Left: r 2 =0.6707) and PBS group (Right: r 2 =0.9937; Left: r 2 =0.9757) increased with fetal age (p 2 =009816; Left: r 2 =0.07643). DISCUSSION This paper is the first to report testicular volume correlations with fetal parameters in anencephalic and PBS fetuses. We observed significant alterations in testicular growth in the anencephalic group compared to the control group and we 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 PBS, anencephalic and controls and the small sample size are limitations of this study. Further studies should be performed to confirm our findings. CONCLUSIONS Testicular growth is slower and does not show significant correlations with fetal parameters in anencephalic fetuses. We did not observe significant differences in testicular development in PBS fetuses.