What is the embryonic development of gonads and how does the process contribute to the abdominal hernias?

Updated: Jul 23, 2019
  • Author: Assar A Rather, MBBS, MD, FACS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Gonads develop on the medial aspect of the mesonephros during week 5 of gestation. The kidney then moves cephalad, leaving the gonad to reside in the pelvis until month 7 of gestation. During this time, it retains a ligamentous attachment to the proximal gubernaculum.

The gonads then migrate along the processus vaginalis, with the ovary descending into the pelvis and the testis being wrapped within the distal processus (tunica vaginalis). The processus fails to close adequately at birth in 40-50% of boys. Therefore, other factors play a role in the development of a clinical indirect hernia. A familial tendency exists, with 11.5% of patients having a family history. The relative risk of inguinal hernia is 5.8 for brothers of male cases, 4.3 for brothers of female cases, 3.7 for sisters of male cases, and 17.8 for sisters of female cases.


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