Clinics in Andrology – serie

An international group of in­ of the contributors will help to intensify research vestigators have contributed reviews designed to and development of improved methods for safely be informative to medical, graduate, and post­ regulating male fertility.

This volume represents the Proceedings of the World Conference on Embryo Transfer, In Vitro Fertilization and Instrumental Insemination held on September 24-27, 1980 in Kiel, West Germany. Professor Dr. L. Mettler and Dr. H. H. Riedel of Frauenklinik der UniversiUit in Kiel were the local co- chairpersons, who contributed very richly to the program. Basic research, clinical trials, preparation of manuscripts, editorial assistance and presentation of results were generously supported by the following institutions and organizations: Kulturministerium des Landes Schleswig-Holstein Medizinische FakuItat der Christian-Albrechts-UniversiUit, Kiel Wayne State University School of Medicine; Detroit, Michigan, USA C. S.Mott Center for Human Growth and Development; Detroit, Michigan, USA Universitats-Frauenklinik und Hebammenlehranstalt; Kiel, West Germany Serono GmbH; Freiburg, West Germany Hutzel Hospital; Detroit Medical Center; Detroit, Michigan, USA Deutsche Gesellschaft fUr Gynaekologie und Geburtshilfe; West Germany Deutsche Gessellschaft zum Studium der Fertilitat und Sterilitat; Sektion Andrologie Thanks are also due to Aponti GmbH (5000 Koln 21), Bayropharm GmbH (5000 Koln 80), Deutsche Lufthansa (5000 Koln), Organon GmbH (8024 Oberschleissheim), Winthrop GmbH (6080 New Isenburg), and Wisap GmbH (8029 Sauerlach), for financial assistance. Sincere appreciation and gratitude are due to the contributors who meticulously prepared their chapters; to Ms Jackie Mucci for editorial skills and assistance, and Ms. Jackie Smieska for editorial help. Thanks are also due to Dr. H. D. Brackebusch for his assistance during the conference; to Ms. E. Seiss for her secretarial assistance; and to Mr.

Andrology, a counterpart to gynecology, deals with the study of the male reproductive organs. Clinical andrology has been neglected primarily because of the lack of relevant, accurate laboratory methods for functional analysis, but in the last decade substantial progress has been made in the understanding of male reproductive biology. This progress has resulted from modern tech­ niques and instrumentation in microanatomy, immunology, neurophysiology, pathology, genetics, endocrinology, biochemistry, biophysics, urology and surgery. These studies are scattered in such a wide spectrum of journals that andrologists can hardly keep abreast of the advances. There have been numerous textbooks on the testes, male accessory organs and semen but the clinical aspects of andrology have not received similar emphasis. Since literature concerning clinical andrology is extensive and widely scattered in many different publica­ tions, we hope that a useful purpose will be served by summarizing the more pertinent material in a series of volumes which can be made readily available to students of andrology. It was decided that a series of specialized monographs should be devoted to clinics in andrology. These ten volumes of the series are an attempt to coordinate anatomical, physiological, biochemical, endocrinological, pharmacological and immunological aspects of the spermatozoa, testes, epi­ didymis and other accessory genital organs. Little is known about the effect of diet, diseases, environmental factors and drugs on male reproduction. The interest in developing new male contraceptive methods will stimulate research in andrology.

During the past decade extensive investigations have been done on the testis. Since the observations have been published in many different journals. it seemed appropriate to bring together and summarize some of the pertinent findings in a single volume. Twenty-eight scientists and clinicians from nine countries have contributed to this book. They have reviewed the literature and presented their own, new observations on the developmentaL anatomicaL physiologicaL biochemical and pathological aspects of the descended and cryptorchid testis. In addition, several contributors have evaluated the usefulness of certain animals as models for systematically studying specific aspects of cryptorchidism. It is hoped that this volume will serve as a useful summary and reference for those working in this area and that it will encourage further research in testicular physiopathology. The editor thanks the contributors for their enthusiasm, cooperation and meticulous writing of the chapters. The support of the Departments of GynecologyjObstetrics and the Department of Physiology of Wayne State University School of Medicine. Detroit and the assistance from the staff of Martinus Nijhoff are gratefully acknowledged. The cheerful cooperation of Miss Lori Rust and Miss Penny Stoops who helped to type and assemble the volume is most deeply appreciated.

In the last decade, physicians have witnessed a publication will serve as a stimulus to surgeons growing awareness of and concern with diseases of concerned with male reproductive disorders to in­ the male reproductive tract. Stimulated by this tensify their personal research attempts to develop interest, a refinement and re-evaluation of existing better therapy for diseases referable to the male reproductive system. It is finally hoped that this surgical techniques for treatment of male repro­ ductive disorders has been concurrently appreci­ publication will stimulate critical analysis of what ated. Rapid progress in this area has resulted we feel are currently accepted surgical modes of primarily from a cooperative effort from those therapy and to better promote a general inter­ specialists in the areas of microsurgery, medical change of clinical information referable to these and surgical oncology, endocrinology and neuro­ disorders. physiology, pathology, immunology, genetics and Those who have provided the text and illustra­ biochemistry. tions for this volume have contributed a significant As the surgical treatment of diseases and ab­ amount of work, and we hope that they feel their normalities of the male reproductive system has material has been well used. The editors also wish to expanded, so have the articles describing these often thank Mr.

Many of the studies discussed in this book were addition to discussions of a variety of hormonal, presented at the First Pan American Congress of biochemical, immunological, physical, and me­ Andrology, which was held in Caracas, Venezuela, chanical approaches. It is our hope that the efforts in March 1979. An international group of in­ of the contributors will help to intensify research vestigators have contributed reviews designed to and development of improved methods for safely be informative to medical, graduate, and post­ regulating male fertility. graduate students, as well as clinicians and in­ vestigators working in the area of male reproduc­ G. R. CUNNINGHAM tion. Current physiological concepts that may W. B. SCHILL provide insight for new initiatives are examined in E. S. E. HAFEZ TABLE OF CONTENTS Preface v Contributors IX Foreword by C. SCHIRREN XI 1. PHYSIOLOGY OF MALE REPRODUCTION 1. Hormonal regulation of testicular function 5 P. FRANCHIMONT 2. Inhibin: new gonadal hormone 15 P. FRANCHIMONT, A. DEMOULIN, J. VERSTRAELEN-PROYARD, M. T. HAZEE-HAGELSTEIN, and J. P. BOURGUIGNON 3. Morphological features of the epididymis: possible significance in male contraception 25 T. D. GLOVER 4. Regulatory physiology of male accessory organs 35 E. S. E. HAFEZ and G. R. CUNNINGHAM 5. Methods for evaluating contraceptive techniques 41 T. Z. HOMONNAI and F. G. PAZ II. HORMONAL CONTRACEPTION 6. Inhibition of male reproductive processes with an LH-RH agonist 55 A. CORBIN and F. J. BEX 7.

In the last decade substantial progress has been scientists and clinicians to intensify their research made in the understanding of prostatic physio- for better diagnostic techniques. Thanks are due to pathology by the application of modern techniques the contributors who prepared their chapters me- and instrumentation in microanatomy, immunol- ticulously. Thanks also are due to Ms. Lori Rust ogy, neurophysiology, pathology, genetics, endo- for her editorial skills, and to Mr. Jeffrey Smith of Martinus Nijhoff for his fine cooperation during crinology, biochemistry, biophysics and surgery. An attempt is made in this volume to coordinate the production of this volume. anatomical, physiological, biochemical, endocri- nological, pharmacological and immunological as- pects of human prostatic carcinoma. It is hoped E.S.E. HAFEZ that this volume will serve as a stimulus to basic Detroit, Michigan PROSTATIC CARCINOMA: BIOLOG Y AND DIAGNOSIS 1. BIOLOGICAL ASPECTS 1. FUNCTIONAL ANATOMY OF THE PROSTATE E. SPRING-M ILLS and A. KRALL I. EMBRYOLOGY into smooth muscle cells and collagen secreting fibroblasts.These cells form the stroma which ensheaths the branching glands and ejaculatory The prostate gland develops from solid. endo- ducts as they pass from the junction of the vas dermal outgrowths of urogenital sinus epithelium deferens and seminal vesicles to the urethra.

The subject matter in this volume was derived from papers presented at the Pediatric Andrology session of the 1st Pan American Congress of Andrology held in Caracas, Venezuela in February 1979, as well as from selected additional manuscripts of interest in this field. Prior to this session, identification of a distinct discipline and specialty devoted to pediatric andrology had not occurred, nor had it been conceptualized. Pediatric andrology encompasses many different areas: disorders of sexual development, structural disease of the genital organs, normal and abnormal puberty, undescended testes, genital tumors, gonadal function and its relationship to growth, virilization, fertility and gender identity all represent areas of specific interest, to name but a few. Andrology itself is a unique field, bringing together clinicians and basic scientists with diverse back­ grounds. It should be noted that between one-half and three-quarters of the clinicians contributing to this issue conduct basic research as well. It has been this unique blend of basic research and clinical medicine which has done much to unravel many of these problems characteristic of this field.