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Updated: Aug 21 2022

Genital Embryology

  • Overview
    • Week 1-6
      • embryo is sexually indifferent
      • genetically male and female embryos are phenotypically the same
      • both male and female have mesonephric (Wolffian) ducts at this stage
    • Week 7
      • sexual differentiation occurs
    • Week 12
      • sex of embryo can be distinguished based on external genitalia
    • Week 20
      • phenotypical differentiation is complete
  • Male vs. Female Differentiation
    • Mesonephric (wolffian) duct
      • needs to be induced to develop
        • by testosterone from the Leydig cells of testes
      • forms male internal sexual organs: Seminal vesicles, Epididymis, Ejaculatory duct, Ductus deferens
    • Paramesonephric (müllerian) duct
      • default development but can be suppressed
      • forms female internal sexual organs: fallopian tube, uterus, upper 1/3 of vagina (lower 2/3 from urogenital sinus)
    • Female
      • default phenotypic differentiation
      • mesonephric duct degenerates and paramesonephric duct develops
    • Male
      • SRY gene (Y chromosome) produces testis-determining factor which is necessary for testes development
      • testes gives rise to
        • sertoli cells: produces Müllerian inhibitory factor suppressing the development of paramesonephric ducts
        • leydig cells: produces androgens stimulating development of mesonephric ducts
  • Male/Female Genital Homologues
      • Dihydrotestosterone Results in Developement
      • Common Precursor
      • Estrogen Results in Development
      • Glans penis
      • Genital tubercle
      • Glans clitoris
      • Corpus cavernosum and spongiosum
      • Genital tubercle
      • Vestibular bulbs
      • Bulbourethral glands (of Cowper)
      • Urogenital sinus
      • Greater vestibular glands (of Bartholin)
      • Prostate gland
      • Urogenital sinus
      • Urethral and paraurethral glands (of Skene)
      • Ventral shaft of penis (penile urethra)
      • Urogenital folds
      • Labia minora
      • Scrotum
      • Labioscrotal swelling
      • Labia majora
  • Female Genital Abnormalities
    • Unicornate Uterus
      • one paramesonephric fails to develop
    • Bicornuate Uterus
      • due to incomplete/partial fusion of the paramesonephric ducts
      • associated with urinary tract abnormalities and infertility
    • Uterus didelphys
      • no fusion between the two paramesonephric ducts resulting in a "double uterus"
    • Müllerian agenesis
      • failure of paramesonephric ducts to develop resulting in abnormalities of the upper portion of the vagina, cervix, uterus, and fallopian tubes
  • Male Genital Abnormalities
    • Hypospadias
      • failure of urethral folds to fuse
      • resulting in opening of penile urethra on inferior side of penis
      • susceptible to UTI's
      • surgery is recommended for treatment
    • Epispadias
      • faulty positioning of genital tubercle
      • resulting in penile urethra opening on superior side of penis
      • associated with exstrophy of the bladder
    • Cryptochidism
      • failure of testes to descend into scrotum (undescended testes)
      • testes can be found in inguinal canal or abdominal canal
      • can lead to infertility if both are undescended
      • observable within 3 months of birth
    • Hydrocele
      • processus vaginalis remains patent allowing fluid to flow in
      • resulting in a fluid filled sac in the scrotum
      • can differentiate from tumor by shining light through testes
      • hydrocele allows light to flow through whereas a tumor does not
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