322 



PHYSIOLOGY OF GONADS 



run to the walls of the tubules and enter the 

 membrana propria to reach the Sertoli cells. 



Experimental studies on the significance 

 of the sympathetic nervous system with re- 

 gard to testicular function have been only 

 sporadically performed in lower animals. 

 Coujard (1952,1954) found that the sympa- 

 thetic ganglia along the vas deferens are 

 most important to testicular development in 

 the guinea pig. If these ganglia are injured, 

 hypoplasia and aspermatogenesis of the 

 testis follow. Unilateral removal of the pros- 

 tatovesiculodeferential ganglion causes ipsi- 

 lateral testicular immaturity. Defects of 

 spermatogenesis also are noted when distant 

 lesions in the sympathetic trunk are pro- 

 duced. Coujard concluded that the sympa- 

 thetic system is an obligatory intermediate 

 between gonadotrophic hormones and the 

 testis. Somewhat similar studies have been 

 reported on the cat (King and Langworthy, 

 1940) . If 7.5 cm. of the sacral and lumbar 

 ganglionic chain are removed unilaterally, 

 cessation of spermatogenesis occurs on the 

 affected side within 2 or more weeks. The 

 Leydig cells remain normal. Bilateral ex- 

 tirpation of strips of the ganglionic chain 

 leads to reduction in spermatogenesis. In 

 addition Weidenmann (1952) reported a 

 diminution in volume of the Leydig cells 

 after lumbar sympathectomy in cats. De- 

 struction of the spinal cord by ultrasound in 

 mice at levels from the eighth to the tenth 

 thoracic segment had no effect on testicular 

 weight, morphology, or spermatogenesis 

 (Josimovich, 1958). 



Lumbar sympathectomy in man has 

 yielded variable results. Bandmann (1950) 

 found atrophy of the testis and loss of po- 

 tentia after unilateral lumbar sympathec- 

 tomy; sperm examinations before and after 

 operation disclosed deterioration in all of 

 his cases. However, Alnor (1951) could not 

 observe any effects in 14 patients after 

 unilateral lumbar sympathectomy, and 

 Kment (1951) found a temporary increase 

 in potency in men after procaine block of 

 the trunk. The effect of lumbar sympathec- 

 tomy in man clearly needs more decisive 

 study. 



The poor sexual status of Iniinan para- 

 plegics has led many authors to conclude 

 that the nervous system controls testicular 

 function in man. Apart from the muscular 



disability of male paraplegics, such symp- 

 toms and signs as gynecomastia, loss of 

 potency, atrophy of the testes, creatinuria, 

 proteinuria, a decreased basal metabolic 

 rate, loss of sex hair, and decreased excre- 

 tion of 17-ketosteroids suggest testicular in- 

 sufficiency (Cooper and Hoen, 1949, 1952; 

 Cooper, Rynearson, Bailey and MacCarty, 

 1950; Cooi^er, Rynearson, MacCarty and 

 Power, 1950). The extent to which these 

 changes occur in paraplegics is debatable, 

 and certainly not all changes are always 

 present in any one patient. A study by 

 Talbot (1955) of 400 paraplegic and quad- 

 riplegic patients showed that two-thirds 

 were capable of achieving erection, and that 

 one-third of these had successful inter- 

 course. One-twentieth were fertile. It is 

 obvious, then, that potency and fertility are 

 not invariably lost. The histologic appear- 

 ance of the testis in paraplegics has been 

 determined by both biopsy and necropsy. In 

 contrast to the variability in symptoms, the 

 histologic appearance of the testis is more 

 uniform. Atrophy of the tubule occurs, of- 

 ten with disai)pearance of all germinal epi- 

 thelium except the Sertoli cells. The tubular 

 wall is thickened. Leydig cells are present 

 but may be found in clumps, giving the 

 appearance of hyperplasia (Keye, 1956). 

 Perusal of most of the illustrations showing 

 atrophic testes in paraplegic men (Stem- 

 mermann, Weiss, Auerbach and Friedman, 

 1950; Klein, Fontaine, Stoll, Dany, and 

 Frank, 1952; Bors, Engle, Rosenquist and 

 Holliger, 1950) indicates that all stages of 

 degeneration may be encountered. Some 

 testes resemble those in adult seminiferous 

 tubular failure, and others, especially those 

 showing severe atrophy, resemble cryptor- 

 cliid testes. It is most difficult to determine 

 from a testis containing only Sertoli cells 

 and clumped Leydig cells what the nature 

 of the pathologic process was, because all 

 tyi:)es of atrophy end in the same general 

 histologic picture regardless of cause. 



jMental disease and mental stress are said 

 to affect the testis. Jankala and Naatanen 

 (1955) found that severely disturbed rats, 

 presumably under "mental strain," showed 

 marked atrophy of the testis within 6 weeks. 

 The severity of this atrophy is evident from 

 the finding that only Sertoli cells remained. 

 Caged dogs, apparently under mental strain, 



