PATHOLOGICAL ANATOMY OF THE TESTICLE 477 



these cases, the gubernaculum is always hypotrophic, and sometimes 

 absent. 



If the testicle descends farther, it produces inguinal ectopia the 

 common variety. The position may be internal, if the testicle is at the 

 internal ring ; interstitial, if it is in the abdominal wall ; or external, if it 

 is at the external ring. Since cryptorchidism is the rule in aplasia of the 

 abdominal wall muscles, we may assume that the migration of the testicle 

 is in some way associated with the normal development of the abdominal 

 wall. 



If the testicle lies below the external ring, but not in its normal posi- 

 tion, the condition is called infra-inguinal ectopia. This is of little im- 

 portance, since the testes remain normal and often descend later to their 

 normal positions. 



Aberrant Migration. When the testicle seeks an abnormal position, it 

 may be considered that ( 1 ) the implantation of the gubernaculum has been 

 faulty, or (2) pressure or trauma have caused the ectopia. The ectopias 

 resulting from aberrant migration may be classified as follows: 



Intm-dbdominal. 



(a) pelvic in the small pelvis. 



(b) deep crural the testis descends through the femoral ring to 

 lie under the cribiform fascia (like femoral hernia). 



Extra^abdominaL 



(a) superficial crural usually caused by pressure on a normally 

 descending testis ; fairly common. 



(b) cruro-scrotal the testis lies in the cruro-scrotal fold ; rare. 



(c) pubo-penile at the base of the penis, in front of the pubis; 

 rare. 



(d) penile beneath the skin of the penis; very rare. 



(e) subcutaneous abdominal the testis slides out under the skin at 

 varying distances from the external ring; sometimes it ree'n- 

 ters the muscles higher up. 



(f) perinea! the testis lies beneath the skin of the perineum; 

 eighty-seven cases reported. 



(g) transverse lies in the opposite side of the scrotum ; five cases 

 reported. 



Intermittent Migration, Occasionally, the vaginal process remaining 

 patent, the testicle may move up and down between the scrotum and the 

 internal inguinal ring, or even the abdomen, recalling the arrangement 

 in certain animals (rodents). This condition is very rare. 



