Development

Dr Mandar Ambike
Professor and HOD
Anatomy Department
 Development of urinary & genital system
•Develops from the Intermediate mesoderm

•Urogenital ridge develops on the dorsal body wall

•One Part -nephrogenic cord and

Other part - genital ridge.
The urogenital ridge consists of mesonephros
and gonad
Intermediate mesoderm form segments of nephrotome
units .
The lateral portions of the nephrotomes unite, forming a
longitudinal mesonephric duct on each side of the
embryo.
 Development of the Gonadal System
The gonads develop as primordial germ cells that form in
the wall of the yolk sac close to the allantois
Germ cells migrate along the dorsal mesentery of the
hindgut to invade the genital ridges.
 Development of the Gonadal
System

Coelomic epithelium covering gonadal ridge - grow as

sex cords into underlying mesenchyme

Proliferation of epithelium on the gonadal ridge by 5

weeks.

Derived from :
•Mesothelium of posterior abdominal wall
Primordial germ cells surrounded by –
primitive sex cords.
this stage the gonad - "indifferent"
In embryos with XX sex chromosomes the cortex
of indifferent gonad differentiate into an ovary
and the medulla regresses.

In embryos with XY sex chromosomes, the

medulla of an indifferent gonad differentiates into
a testis and the cortex regresses- except for
vestigial remnants.
Sex determination:
•Depends whether an X-bearing or a Y-bearing sperm
fertilizes the ovum.

•Before 7 weeks the gonads of both sexes are identical.

Indifferent gonads

•Development of a male phenotype requires a

Y-chromosome.

•The short arm of this chromosome is critical for sex

determination .
•A SRY gene produces - Testis-determining factor(TDF)
present in - short arm of a Y-chromosome.

•Under the influence of TDF the gonad develops into -

testis.

•Androgen TESTOSTERONE produced by the fetal testes

determines Maleness.

•Female sexual difference - does NOT depend on

hormones-
it occurs even in the absence of ovaries.
The mesonephros consists of excretory tubules that
contact a blood vessel medially and enter the
Mesonephric (Wolffian) duct laterally.
A Paramesonephric duct forms from the epithelium on
the surface of the urogenital ridge.
 Development of Testis

TDF induces primary sex cords to condense and extend

into the medulla of the indifferent gonad.

Connection of sex cords with surface epithelium is lost

when a thick fibrous capsule “Tunica albuginea” forms.

Tunica albuginea is characteristic of testicular

development.
In the male the primitive sex cords form the testis and
the rete testis cords.
Rete testis communicate with tubules of mesonephric
system, thus linking the testis to the mesonephric duct.
Seminiferous tubules
canalize by puberty.

Sertoli cells derived from

surface epithelium

Spermatogonia derived
from - primordial germ
cells

The mesonephric duct

becomes the ductus
deferens.

The Leydigs cells –

mesoderm
of Gonadal ridge
Descent of the testes carries the cranial end of the
mesonephric duct caudally.
Gradually enlarged testis separates from the
degenerating mesonephros –
suspended by it own mesentery-Mesorchium.

By 8th week Leydig cells derived from mesenchyme

secrete androgenic hormones.
Testosterone & androstenidione induce masculinization
of mesonephric ducts and external genetalia.

Fetal testis also produces a glycoprotein

“AntiMullerian” hormone(AMH) or
mullerian inhibiting hormone(MIH)
by the sustentacular cells of Sertoli.
 Development of Ovaries
Ovary is not identifiable histologically until 10th week.

Development is slower than the testis.

Primary sex cords not so prominent extend into the medulla

o form a rudimentary rete ovarii.

Primary sex cords and rete ovarii degenerate and disappear.

Secondary sex cords(cortical) extend from surface
(Coelomic) epithelium.

Primordial germ cells are incorporated into them.

At 16 weeks these cords break up into clusters of

primordial follicles- - each containing a oogonium

Many oogonia degenerate before birth (2 million)

There are about - 2 million primary oocytes

in newborn female infant.

Only 400 of these become secondary oocytes and

are expelled one at a time on the ovulation day of a
cycle.
The surface epithelium separates from the follicles by a
thin
fibrous capsule, tunica albuginea

As it separates from the regressing mesonephros,

it is suspended by the mesovarium..
In the female, the primitive sex cords (medullary cords)
degenerate.
Subsequently, there is no communication between
the gonad and the mesonephroscom
In the female, the mesonephric ducts degenerate, while
the paramesonephric ducts form - fallopian tubes and
uterus.
Remnants of the mesonephros are located in the
mesentery of the ovary (mesovarium).
The tissues that form the round ligament of the uterus are
analagous to the male gubernaculum
Descent of Gonads
Testis :
•Inguinal canal is a pathway
for descent.

•Gubernaculum testis is a
fibromuscular band attaches
inferior pole of testis to the
internal surface of labioscrotal
swellings

•Processus vaginalis
- evaginated part of the
[Link]
develops ventral to the
gubernaculum.
Descent associated with:

•Enlargement of testis and

atrophy of the mesonephroi
that allows movement of the testis caudally.

•Enlargement of Processus vaginalis.

•Gubernaculum pulls the testes towards the

scrotum.

•Increased intra-abdominal pressure.

•Androgens secreted by testes control descent.

•Atrophy of PMNDs induced by MIS

•26 weeks- testes have descended from the
posterior abdominal wall to the Deep Ring.
•7th month – enters canal
8th month – in the Inguinal canal
In full term (9th month) the testes are
within the scrotum.
ompared adult anatomy

•Mode of descent
explains why the
ductus deferens is
anterior to the
ureters

•Explains the course

of the testicular
vessels.
•Vaginal process carries layers of the abdominal wall with
it and form the coverings of the spermatic [Link] testis.
•Deep ring is an opening in the TF
•Superficial ring is an opening in the EO muscle..
•Extension of transversalis fascia>>internal spermatic
fascia.
•Extension of internal oblique muscle>>cremasteric
fascia.
•Extension of external oblique aponeurosis>>external
spermatic fascia.
 Cryptorchidism or Undescended Testes

“Hidden testis”- occurs in 30% of premature males.

Both testes descend into the scrotum by end of 1st

year.

Unilateral or bilateral.

May be in the abdominal cavity or in the inguinal

canal.
Ectopic Testes
After passing the inguinal
canal, the testes may
deviate and lodge in various
positions.
Interstitial ectopic-external
to EO aponeurosis
Proximal part of medial
thigh
Dorsal to the penis.
On the opposite side-
crossed ectopia.
Congenital Inguinal Hernia
Persistent communication b/w peritoneum and
processus vaginalis.

Hydrocele
Accumulation of fluid in a patent processus
vaginalis that is too small to allow any
herniation .

Fluid is around the testes as in a hydrocele of the

testes or around the spermatic cord as in
hydrocele of the cord
 Normal scrotum:
the processus vaginalis and tunica
vaginalis are obliterated and contain
no fluid.
Noncommunicating hydrocele:
the processus vaginalis is obliterated
so no fluid can move between the
abdomen and the scrotum, but the
tunica vaginalis contains fluid.

Communicating hydrocele:
the processus vaginalis is still open,
allowing fluid to move between the
abdomen and the tunica vaginalis in
the scrotum.
 Descent of Ovaries.

•Also descend from posterior abdominal wall but

just inferior the pelvic brim.

•Gubernaculum ovari is attached to the uterus near the

attachment of the uterine tube.

•Cranial part of gubernaculum>>ovarian ligament.

•Caudal part>>round ligament of uterus.

•Round ligament passs through the inguinal canal to get

attached to the labia majora.

•Relatively small processus vaginalis forms the

canal of Nuck
 Development of the Genital Ducts

•Mesonephric ducts (Wolffian) >> male

•Paramesonephric ducts(Mullerian) >> female

In males
Under testosterone influence and MIS (Mullerian inhibiting
substances),
• efferent ductules are derived from mesonephric tubules
• proximal part of each mesonephric duct>>epididymis
• remainder >>ductus deferens and ejaculatory duct.
• A lateral outgrowth from the caudal end of each
mesonephric duct >> seminal vesicle.
Mesonephric ducts & Derivatives
Mesonephric ducts in Male and Femal
 Mesonephric remnants in
Females
Distal ends of MNDs in females degenerate.

Rudiments are:
•Cranial ends of MNDs –Appendix vesiculosa
(HYDATID of MORGAGNI)
•Epoophoron
•Paraoophoron
•Gartner’s duct
Paramesonephric Ducts in Female & Male
In females
Female sexual
development does not
depend on presence of
hormones or ovaries.

PMNDs >>most of
female genital tract.

Uterine tubes from

unfused parts of PMND

Caudal fused parts

>>uterovaginal
primordium

-Uterus
-Vagina- upper 1/3rd
Fusion of PMNDs bring the peritoneal folds that form
Right & Left Broad ligaments and
2 pouches- Rectouterine & Vesicouterine
Development of Vagina
•Epithelium derived from
endoderm of UGS

•Fibromuscular wall from

mesoderm around

•Sinus tubercle formed

by contact of UGS and
uterovaginal primordium.

•Sinus tubercle induces

formation of paired
endodermal outgrowths
called Sinovaginal bulbs.
•Sinovaginal bulbs fuse to form a vaginal plate.
•Centre of plate breaks down forming lumen of vagina.
•Until late fetal life the lumen of vagina is separated
from the cavity of UGS by a Hymen
 Glands

Endodermal outgrowths from the urethra -

urethral glands and
paraurethral glands of Skene.

Outgrowths from UGS –

greater vestibular glands of
Bartholin.
Prostate
•Multiple endodermal
outgrowths from
prostatic urethra.
•Stroma and smooth muscle
from mesoderm around.

Bulbourethral
glands
•Paired outgrowths of
spongy urethra
•Stroma and smooth muscle
from mesoderm around.
EXTERNAL GENITALIA
 Clinical Embryology
Agonadal males
Due to absence of MIS
Testis fails to develop but PMNDs develop.
If testis is removed before initiation of differentiation of
genital ducts- female duct system develops.
Removal of ovaries has NO EFFECT on fetal sexual
development.

Hermaphroditism-
errors of Sex determination and Differentiation
Leads to – Intersexuality
True hermaphroditism-

Ovaries and testicular tissue in same or opposite gonad.

• External Genitalia ambiguous
•These gonads are not fully functional
•70% have 46, XX
•20% have 46, XX/ 46, XY mosaicism
•10% have 46, XY

•Mosaics – Cell with Y – Testes tissue

Without Y – Ovary tissue
•Others – X may have short arm of Y?
Y – sex determining region of some cell -
Mutation
Pseudohermaphroditism-

External genitalia of One sex

Gonads of Other sex

Gonad – Testes – Male Pseudohermaphroditism

Ovaries – Female Pseudohermaphroditism

Sex hormones - abnormality

Female
Pseudohermaphroditis
m

•Have Chromatin positive

nuclei.

•46, XX complement.

•exposure of female
fetuses to excessive
androgens.
•Occurs in masculinising maternal tumours as in
benign adrenal adenoma and arrhenoblastoma of
ovaries
•Virilisation of external genetalia-
clitorial enlargement and labial fusion.
•Congenital adrenal hyperplasia (CAH)
is the common cause.

•Normal ovaries.
Male Pseudohermaphroditism

•Have chromatin negative nuclei.

•Have a 46, XY complement.

•Caused by inadequate production of testosterone and

MIF
by fetal testis leading to inadequate
masculinisation.

• Testes are rudimentary to normal. May not descent

•External Genitalia – female type
•Sertoli cell – MIS – no uterus and Vagina
 Androgen Insensitivity Syndrome
•Persons with AIS formally called
Testicular Feminization Syndrome

•Normal appearing females

(Absence of-
•Presence of testis Androgen
receptors)
•46, XY complement

•External genitalia are female.

•Vagina ends in a blind pouch.

•Uterus and tubes are absent or rudimentary.

•Normal breasts develop but NO MENSTRUATION.

 Anomalies of Uterus, Tubes and Vagina
Result from arrest of development of uterovaginal
primordium as in
•Incomplete fusion of PMNDs.

•Failure of part or one of the PMNDs to develop.

•Incomplete canalisation of vaginal plate.

Uterus didelphys
Double uterus- failure of fusion
of inferior parts of PMNDs.
Bicornuate uterus- duplication
involves only superior part.
Bicornuate with a rudimentary
horn- one PMND is retarded
and does not fuse with the
opposite duct.
Unicornuate uterus- only one
PMND develops.
Absence of vagina and
uterus:
Failure of sinovaginal bulbs to
develop and form vaginal
plate.
Uterus is consequently absent
as it induces the formation of
sinovaginal bulbs.

Vaginal Atresia
Results of failure of
canalisation of vaginal plate.
Failure of inferior end of
vaginal plate to perforate-
Imperforate Hymen
 Vestigial Structures of Genital Ducts

Embryonic ducts Males Females

Indifferent gonad Testis Ovary

Cortex Seminiferous Ovarian
tubules follicles

Medulla Rete testis Rete ovarii

Gubernaculum Gubernaculum Ovarian ligament

testis Round lig of Uterus
Embryonic ducts Males Females

Mesonephric tubules Eff. Ductules Epoophoron

Paradidymis Paraophoron

Mesonephric ducts Appendix of Epidymis. Appendix

vesiculosa

Duct of Epdidymis. Duct of

epoophoron

Ductus deferens Duct of Gartner

Ureter,pelvis,calyces, Same as in males

collecting tubules
ejaculatory ducts &
seminal vesicles
Embryonic ducts Males Females
Paramesonephric ducts Appendix of Hydatid of Morgagni
testis Uterine tubes & Ut.

Urogenital sinus Urinary bladder Same

Urethra except Urethra

navicular fossa

Prostatic utricle Vagina

Prostate gland Urethral & para-

urethral glands

Bulbourethral Greater vestibular

glands glands
Embryonic ducts Males Females

Sinus tubercle Seminal colliculus Hymen

Phallus Penis Clitoris

Glans penis Glans clitoris
Corp. cavernosa penis [Link]
Corp. spongiosum penis Bulb of vestibule

Urogenital Ventral aspect of penis Labium minora

Folds

Labioscrotal Scrotum Labia majora

swellings
 Congenital Anomalies
• Urethral folds may fail to fuse, partially or
completely. When failure to fuse is complete,
the scrotum is in two halves and the genitals
looks like those of a female. If the defect is
confined to the anterior part of the phallus, the
urethra opens on the undersurface of the
penis (hypospadias).