Inguinoscrotal abnormalities in children are best understood by reviewing the underlying embryology of testicular descent and the inguinal region development. At approximately 6 weeks of gestation, the primitive germ cells migrate from the yolk sac to the genital ridge located high on the posterior wall of the abdomen where they differentiate into a testis or an ovary during the next 2 weeks. During the next few weeks of fetal elongation, the gonad becomes located near the internal inguinal ring at 3 months of gestation. During the third month and before testicular descent, the peritoneum bulges into the inguinal canal as the processus vaginalis. The gubernaculum forms from the caudal end of the mesonephros and is attached to the lower pole of the testis, where it serves to guide its descent into the scrotum. Starting in the seventh month of gestation, the testes descend through each inguinal canal, pushing the vaginalis ahead of it toward the scrotum during a few days, and then migrate from the external ring to the lower scrotum during the next 4 weeks.
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