<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.4 20241031//EN"
        "https://jats.nlm.nih.gov/publishing/1.4/JATS-journalpublishing1-4.dtd">
<article  article-type="research-article"        dtd-version="1.4">
            <front>

                <journal-meta>
                                                                <journal-id>anatomy</journal-id>
            <journal-title-group>
                                                                                    <journal-title>Anatomy</journal-title>
            </journal-title-group>
                                        <issn pub-type="epub">1308-8459</issn>
                                                                                            <publisher>
                    <publisher-name>Society of Anatomy and Clinical Anatomy</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id/>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Health Care Administration</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Sağlık Kurumları Yönetimi</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                                                            <article-title>Macroscopic demonstration of the male urogenital system with evidence of a direct inguinal hernia utilizing room temperature plastination</article-title>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                <name>
                                    <surname>Ruthig</surname>
                                    <given-names>Victor A.</given-names>
                                </name>
                                                                    <aff>Institute for Biogenesis Research, John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, HI</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                <name>
                                    <surname>Labrash</surname>
                                    <given-names>Steven</given-names>
                                </name>
                                                                    <aff>Department of Anatomy, Biochemistry and Physiology, John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, HI</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                <name>
                                    <surname>Lozanoff</surname>
                                    <given-names>Scott</given-names>
                                </name>
                                                                    <aff>Department of Anatomy, Biochemistry and Physiology, John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, HI</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                <name>
                                    <surname>Ward</surname>
                                    <given-names>Monika A.</given-names>
                                </name>
                                                                    <aff>Department of Anatomy, Biochemistry and Physiology, John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, HI</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="20161230">
                    <day>12</day>
                    <month>30</month>
                    <year>2016</year>
                </pub-date>
                                        <volume>10</volume>
                                        <issue>3</issue>
                                        <fpage>211</fpage>
                                        <lpage>220</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="20170528">
                        <day>05</day>
                        <month>28</month>
                        <year>2017</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="20161211">
                        <day>12</day>
                        <month>11</month>
                        <year>2016</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 2007, Anatomy</copyright-statement>
                    <copyright-year>2007</copyright-year>
                    <copyright-holder>Anatomy</copyright-holder>
                </permissions>
            
                                                                                                                        <abstract><p>The male urogenital system represents a morphologically complex region that arises from a common embryological origin.However, it is typically studied separately as the excretory system is dissected with the posterior wall of the abdomen while thereproductive features are exposed with the pelvis and perineum dissection. Additionally, the reproductive structures are typicallydissected following pelvic and perineal hemisection obviating a comprehensive and holistic examination. Here, we performeda dissection of the complete male urogenital system utilizing a 70-year-old donor and room temperature silicon plastination.Identification of a direct inguinal hernia during the dissection facilitated a unique opportunity to incorporate a commonabdominal wall defect into the plastination requiring a novel approach to retain patency of relevant structures. Resultsshowed that the typical structures identified in medical gross anatomy were retained in addition to the hernia. Thus, thedescribed approach and the resulting specimen provide valuable and versatile teaching tools for male urogenital anatomy.</p></abstract>
                                                            
            
                                                                                        <kwd-group>
                                                    <kwd>direct inguinal hernia</kwd>
                                                    <kwd>  genital</kwd>
                                                    <kwd>  male</kwd>
                                                    <kwd>  reproductive</kwd>
                                                    <kwd>  urogenital</kwd>
                                            </kwd-group>
                            
                                                                                                                                                    </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">1. Larsen WJ, Sherman LS. Human embryology: development of the
urogenital system. New York (NY): Elsevier Churchill Livingstone;
1993. p. 245.</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">2. Sadler TW. Third to eighth weeks: the embryonic period;
Urogenital system. In: Langman&#039;s medical embryology. 11th ed.
Philadephia (PA): Wolters Kluwer/Lippincott Williams and Wilkins;
2010. p. 77, 246–8, 260–1.</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">3. du Bois AM. The embryonic kidney. In: Rouiller C, Muller AF, editors.
The kidney: morphology, biochemistry, physiology. Vol. 1. New
York (NY): Academic Press; 1969. p. 8–11, 48.</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">4. Gubbay J, Collignon J, Koopman P, Capel B, Economou A,
Münsterberg A, Vivian N, Goodfellow P, Lovell-Badge R. A gene
mapping to the sex-determining region of the mouse Y chromosome
is a member of a novel family of embryonically expressed genes.
Nature 1990;346:245–50.</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">5. Rotondi M, Valenzano F, Bilancioni E, Spano G, Rotondi M,
Giorlandino C. Prenatal measurement of testicular diameter by
ultrasonography: development of fetal male gender and evaluation of
testicular descent. Prenat Diagn 2001;21:112–5.</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">6. Chen H, Midzak A, Luo L-d, Zirkin BR. Aging and the decline of
androgen production. In: Payne AH, Hardy MP, editors. The
Leydig cell in health and disease. Totowa (NJ): Humana Press; 2007.
p. 117–31.</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">7. Sanford EJ, Paulson DF, Rohner TJ, Jr., Santen RJ, Bardin CW.
The effects of castration on adrenal testosterone secretion in men
with prostatic carcinoma. J Urol 1977;118:1019–21.</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">8. Georgiadis EI, Matzoros C, Aliferis C, Batrinos M. Are adrenal and
testicular androgen levels correlated? Horm Metab Res
1992;24:488–91.</mixed-citation>
                    </ref>
                                    <ref id="ref9">
                        <label>9</label>
                        <mixed-citation publication-type="journal">9. Tank PW. The abdomen; the pelvis and perineum. In: Grant’s dissector.
15th ed. Philadelphia (PA): Lippincott Williams and Wilkins;
2013: 89–163.
10. Walter T. Body Worlds: clinical detachment and anatomical awe.
Sociol Health Illn 2004;26:464–88.</mixed-citation>
                    </ref>
                                    <ref id="ref10">
                        <label>10</label>
                        <mixed-citation publication-type="journal">11. von Hagens G, Tiedemann K, Kriz W. The current potential of
plastination. Anat Embryol (Berl) 1987;175:411–21.</mixed-citation>
                    </ref>
                                    <ref id="ref11">
                        <label>11</label>
                        <mixed-citation publication-type="journal">12. Labrash S, Lozanoff S. Standards and guidelines for willed body
donations at the John A. Burns School of Medicine, 2007. Hawaii
Med J 2007;66:72,74–5.</mixed-citation>
                    </ref>
                                    <ref id="ref12">
                        <label>12</label>
                        <mixed-citation publication-type="journal">13. Clark RK. Your reproductive system; Your urinary system. In:
Anatomy and physiology: understanding the human body. Sudbury
(MA): Jones and Bartlett Publishers; 2005. p. 267-72, 371–88.</mixed-citation>
                    </ref>
                                    <ref id="ref13">
                        <label>13</label>
                        <mixed-citation publication-type="journal">14. Moore KL, Dalley AF, Agur AMR. Abdomen; pelvis and perineum.
In: Clinically oriented anatomy. 6th ed. Philadelphia (PA): Wolters
Kluwer/Lippincott Williams and Wilkins; 2010. p. 181–438.</mixed-citation>
                    </ref>
                                    <ref id="ref14">
                        <label>14</label>
                        <mixed-citation publication-type="journal">15. Schünke M, Schulte E, Schumacher U. Abdomen and pelvis. In:
Gilroy AM, MacPherson BR, Ross LM, editors. Atlas of anatomy.
2nd ed. Stuttgart: Thieme; 2012. p. 124–48.</mixed-citation>
                    </ref>
                                    <ref id="ref15">
                        <label>15</label>
                        <mixed-citation publication-type="journal">16. Setchell BP, Maddocks S, Brooks DE. Anatomy, vasculature, innervation,
and fluids of the male reproductive tract. In: Knobil E, Neill
JD, Greenwald GS, Markert CL, Pfaff DW, editors. The physiology
of reproduction. 2nd ed. Vol. 1. New York (NY): Raven Press;
1994. p. 1063–175.</mixed-citation>
                    </ref>
                                    <ref id="ref16">
                        <label>16</label>
                        <mixed-citation publication-type="journal">17. Benson GS. Male sexual function: erection, emission, and ejaculation.
In: Knobil E, Neill JD, Greenwald GS, Markert CL, Pfaff DW,
editors. The physiology of reproduction. 2nd ed. Vol. 1. New York
(NY): Raven Press; 1994. p. 1489–506.</mixed-citation>
                    </ref>
                                    <ref id="ref17">
                        <label>17</label>
                        <mixed-citation publication-type="journal">18. Henry RW. Silicone plastination of Biological tissue: Room-temperature
technique – North Carolina technique and products. Journal of
the International Society for Plastination 2007;22:26–30.</mixed-citation>
                    </ref>
                                    <ref id="ref18">
                        <label>18</label>
                        <mixed-citation publication-type="journal">19. Saypol DC, Lipshultz LI, Howards SS. Varicocele. In: Lipshultz LI,
Howards SS, editors. Infertility in the male. New York (NY):
Churchill Livingstone; 1983. p. 299–313.</mixed-citation>
                    </ref>
                                    <ref id="ref19">
                        <label>19</label>
                        <mixed-citation publication-type="journal">20. Rutkow IM. Demographic and socioeconomic aspects of hernia
repair in the United States in 2003. Surg Clin North Am 2003;
83:1045–51.</mixed-citation>
                    </ref>
                                    <ref id="ref20">
                        <label>20</label>
                        <mixed-citation publication-type="journal">21. Evers BM. Small Bowel. In: Sabiston DC, Townsend CM, editors.
Sabiston textbook of surgery: the biological basis of modern surgical
practice. 18th ed. Philadelphia (PA): Saunders/Elsevier; 2008. p. 873–
916.</mixed-citation>
                    </ref>
                                    <ref id="ref21">
                        <label>21</label>
                        <mixed-citation publication-type="journal">22. McIntosh A, Hutchinson A, Roberts A, Withers H. Evidence-based
management of groin hernia in primary care - a systematic review.
Fam Pract 2000;17:442–7.
23. Ruhl CE, Everhart JE. Risk factors for inguinal hernia among adults
in the US population. Am J Epidemiol 2007;165:1154–61.</mixed-citation>
                    </ref>
                                    <ref id="ref22">
                        <label>22</label>
                        <mixed-citation publication-type="journal">24. Conze J, Klinge U, Schumpelick V. Part XIII. Abdominal wall - hernias.
In: Holzheimer RG, Mannick JA, editors. Surgical treatment –
Evidence-based and problem-oriented. München: Zuckschwerdt
Verlag; 2001. p. 611–8.</mixed-citation>
                    </ref>
                                    <ref id="ref23">
                        <label>23</label>
                        <mixed-citation publication-type="journal">25. Holzheimer RG. Inguinal hernia: classification, diagnosis and treatment
– classic, traumatic and Sportsman&#039;s hernia. Eur J Med Res
2005;10:121–34.</mixed-citation>
                    </ref>
                                    <ref id="ref24">
                        <label>24</label>
                        <mixed-citation publication-type="journal">26. Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, Dunlop DD, Reda
DJ, McCarthy M Jr, Neumayer LA, Barkun JS, Hoehn JL, Murphy
JT, Sarosi GA Jr, Syme WC, Thompson JS, Wang J, Jonasson O.
Watchful waiting vs repair of inguinal hernia in minimally symptomatic
men: a randomized clinical trial. JAMA 2006;295:285–92.</mixed-citation>
                    </ref>
                                    <ref id="ref25">
                        <label>25</label>
                        <mixed-citation publication-type="journal">27. Ein SH, Njere I, Ein A. Six thousand three hundred sixty-one pediatric
inguinal hernias: a 35-year review. J Pediatr Surg 2006;41:980–
6.</mixed-citation>
                    </ref>
                                    <ref id="ref26">
                        <label>26</label>
                        <mixed-citation publication-type="journal">28. Nehme AE. Groin hernias in elderly patients. Management and
prognosis. Am J Surg 1983;146:257–60.</mixed-citation>
                    </ref>
                                    <ref id="ref27">
                        <label>27</label>
                        <mixed-citation publication-type="journal">29. van Wessem KJ, Simons MP, Plaisier PW, Lange JF. The etiology
of indirect inguinal hernias: congenital and/or acquired? Hernia
2003;7:76–9.</mixed-citation>
                    </ref>
                                    <ref id="ref28">
                        <label>28</label>
                        <mixed-citation publication-type="journal">30. Nano M. Technique for inguinal hernia repair in the elderly patient.
Am J Surg 1983; 146:373–5.</mixed-citation>
                    </ref>
                                    <ref id="ref29">
                        <label>29</label>
                        <mixed-citation publication-type="journal">31. Gianetta E, de Cian F, Cuneo S, Friedman D, Vitale B, Marinari G,
Baschieri G, Camerini G. Hernia repair in elderly patients. Br J Surg
1997;84:983–5.</mixed-citation>
                    </ref>
                                    <ref id="ref30">
                        <label>30</label>
                        <mixed-citation publication-type="journal">32. Jenkins JT, O&#039;Dwyer PJ. Inguinal hernias. BMJ 2008;336:269-72.
33. Ralphs DN, Brain AJ, Grundy DJ, Hobsley M. How accurately can
direct and indirect inguinal hernias be distinguished? Br Med J
1980;280:1039–40.</mixed-citation>
                    </ref>
                                    <ref id="ref31">
                        <label>31</label>
                        <mixed-citation publication-type="journal">34. Sanjay P, Fulke JL, Shaikh IA, Woodward A. Anatomical differentiation
of direct and indirect inguinal hernias: Is it worthwhile in the
modern era? Clin Anat 2010;23:848–50.</mixed-citation>
                    </ref>
                                    <ref id="ref32">
                        <label>32</label>
                        <mixed-citation publication-type="journal">35. Bay-Nielsen M, Nilsson E, Nordin P, Kehlet H. Chronic pain after
open mesh and sutured repair of indirect inguinal hernia in young
males. Br J Surg 2004;91:1372–6.</mixed-citation>
                    </ref>
                                    <ref id="ref33">
                        <label>33</label>
                        <mixed-citation publication-type="journal">36. Tamura K, Stickley CD, Labrash SJ, Lozanoff S. Effectiveness of
Plastinated anatomical specimens depicting common sports injuries
to enhance musculoskeletal injury evaluation education. Athletic
Training Education Journal 2014;9:174–81.</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
