Endocrinology and pathology of rete testis and efferent ductules

Endocrine regulation of rete testis and the efferent ductules involves a complex interaction of multiple steroid hormone receptors and their ligands, with what is now called an androgen/estrogen balance. Estrogen receptor-α shows constitutive expression and is unaltered by most experimental treatments, including DES. However, DES causes the loss of androgen receptor in the efferent duct epithelium. Pathological changes in this region often appear to be linked to either excessive fluid reabsorption or the opposite, an inhibition of reabsorption. With both deviations, there will be luminal dilation in the proximal region near the rete testis, and if the lesion is found closer to the testis there will be a greater involvement of rete testis and seminiferous tubules. Pathological changes have been associated with several diseases in man and typically involve the development of large cysts, as can be found in proximal tubule diseases of the kidney.