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1.
Asian Journal of Andrology ; (6): 58-65, 2023.
Article in English | WPRIM | ID: wpr-971003

ABSTRACT

Congenital bilateral absence of the vas deferens (CBAVD) is observed in 1%-2% of males presenting with infertility and is clearly associated with cystic fibrosis transmembrane conductance regulator (CFTR) mutations. CFTR is one of the most well-known genes related to male fertility. The frequency of CFTR mutations or impaired CFTR expression is increased in men with nonobstructive azoospermia (NOA). CFTR mutations are highly polymorphic and have established ethnic specificity. Compared with F508Del in Caucasians, the p.G970D mutation is reported to be the most frequent CFTR mutation in Chinese patients with cystic fibrosis. However, whether p.G970D participates in male infertility remains unknown. Herein, a loss-of-function CFTR p.G970D missense mutation was identified in a patient with CBAVD and NOA. Subsequent retrospective analysis of 122 Chinese patients with CBAVD showed that the mutation is a common pathogenic mutation (4.1%, 5/122), excluding polymorphic sites. Furthermore, we generated model cell lines derived from mouse testes harboring the homozygous Cftr p.G965D mutation equivalent to the CFTR variant in patients. The Cftr p.G965D mutation may be lethal in spermatogonial stem cells and spermatogonia and affect the proliferation of spermatocytes and Sertoli cells. In spermatocyte GC-2(spd)ts (GC2) Cftr p.G965D cells, RNA splicing variants were detected and CFTR expression decreased, which may contribute to the phenotypes associated with impaired spermatogenesis. Thus, this study indicated that the CFTR p.G970D missense mutation might be a pathogenic mutation for CBAVD in Chinese males and associated with impaired spermatogenesis by affecting the proliferation of germ cells.


Subject(s)
Humans , Animals , Mice , Male , Mutation, Missense , Retrospective Studies , Cystic Fibrosis Transmembrane Conductance Regulator/genetics , Infertility, Male/genetics , Mutation , Vas Deferens/abnormalities , Spermatogenesis/genetics
2.
Asian Journal of Andrology ; (6): 73-77, 2023.
Article in English | WPRIM | ID: wpr-970986

ABSTRACT

Patients with congenital unilateral absence of the vas deferens (CUAVD) manifest diverse symptoms from normospermia to azoospermia. Treatment for CUAVD patients with obstructive azoospermia (OA) is complicated, and there is a lack of relevant reports. In this study, we describe the clinical features and evaluate the treatments and outcomes of CUAVD patients with OA. From December 2015 to December 2020, 33 patients were diagnosed as CUAVD with OA in Shanghai General Hospital (Shanghai, China). Patient information, ultrasound findings, semen analysis, hormone profiles, and treatment information were collected, and the clinical outcomes were evaluated. Of 33 patients, 29 patients were retrospectively analyzed. Vasoepididymostomy (VE) or cross VE was performed in 12 patients, the patency rate was 41.7% (5/12), and natural pregnancy was achieved in one of the patients. The other 17 patients underwent testicular sperm extraction as the distal vas deferens (contralateral side) was obstructed. These findings showed that VE or cross VE remains an alternative treatment for CUAVD patients with OA, even with a relatively low rate of patency and natural pregnancy.


Subject(s)
Pregnancy , Female , Humans , Male , Vas Deferens/abnormalities , Azoospermia/surgery , Epididymis/surgery , Retrospective Studies , Tertiary Care Centers , China , Semen
3.
Journal of Modern Urology ; (12): 562-565, 2023.
Article in Chinese | WPRIM | ID: wpr-1006022

ABSTRACT

【Objective】 To introduce a modified microdot two-layer microsurgical vasovasostomy (MVV) and to analyze its effectiveness in patients with vas deferens obstruction caused by inguinal herniorrhaphy. 【Methods】 Clinical data of patients treated during Mar.2015 and Oct.2020 were retrospectively analyzed. According to different surgical methods, the patients were divided into the modified group and traditional group. The general data, intraoperative conditions, efficacies and complications of the two groups were compared. 【Results】 There were 59 cases in the modified group, 54(91.5%) of whom were successfully followed up, and 41 cases in the traditional group, 38(92.7%) of whom were successfully followed up. There were no significant differences in age, inguinal herniorrhaphy history, and unilateral/bilateral ratio between the two groups (P>0.05). The average operation time for unilateral lesions in the modified group was shorter than that in the traditional group [(89.44±24.86) vs. (112.04±43.40) min, P=0.032]. The postoperative patency rate (83.3% vs.73.7%, P>0.05) and natural pregnancy rate (33.3% vs.28.9%, P>0.05) of the modified group and traditional group were comparable. Incision fat liquefaction occurred in 2 cases (3.70%) in the modified group and in 1 case (2.63%) in the traditional group (P>0.05). 【Conclusion】 The modified microdot two-layer MVV is a safe surgical method with comparable effectiveness as the traditional approach. By adjusting the position of the marking points and the order of suturing, it helps the management of sutures, reduces the difficulty of vasovasostomy, shortens operation time, and can be applied to repair vas deferens obstruction caused by inguinal herniorrhaphy.

4.
Asian Journal of Andrology ; (6): 140-145, 2021.
Article in English | WPRIM | ID: wpr-879736

ABSTRACT

Recent data suggest that cystic fibrosis transmembrane conductance regulator (CFTR) gene alterations negatively impact male fertility beyond obstruction. We sought to compare gene alterations, sperm retrieval rates, and intracytoplasmic sperm injection (ICSI) outcomes among men with cystic fibrosis (CF) disease and congenital bilateral absence of the vas deferens (CBAVD) only. We retrospectively evaluated all men who underwent surgical sperm retrieval at two academic, high-volume andrology centers from 2010 to 2018. Only men with documented CFTR alterations and obstructive azoospermia from either CBAVD or CF were included. Differences between groups for CFTR abnormality, sperm retrieval, and ICSI outcomes were statistically analyzed. Overall, 39 patients were included with 10 in the CF and 29 in the CBAVD groups. Surgical sperm retrieval rates were significantly lower in the CF group for sperm concentration (14.8 × 10

5.
Acta cir. bras ; 35(2): e202000201, 2020. tab, graf
Article in English | LILACS | ID: biblio-1100884

ABSTRACT

Abstract Purpose To evaluate the effect of a PP mesh on duct deferens morphology, testicular size and testosterone levels. Methods Forty adult male rats were distributed into groups: 1) no surgery; 2) inguinotomy; 3) mesh placed on the duct deferens; and 4) mesh placed on the spermatic funiculus. After 90 postoperative days, the inguinal region was resected, and blood samples were collected for the measurement of serum testosterone (pg/dl). The ducts deferens were sectioned in three axial sections according to the relationship with the mesh — cranial, medial and caudal. The wall thickness and duct deferens lumen area were measured. Results The morphology of the duct deferens was preserved in all groups. The mesh placement did not alter this morphology in any of the analyzed segments. Surgery, with or without mesh placement, did not alter the morphology, wall thickness or lumen area (p>0.05). In all operated groups, serum testosterone levels were similar (p>0.05) but there was a decrease in testicle size (p<0.05). Conclusion Surgery, with or without mesh placement, did not alter the morphology of the duct deferens and, although this treatment resulted in testicular size reduction, it did not affect serum testosterone levels.


Subject(s)
Animals , Male , Surgical Mesh , Vas Deferens/pathology , Foreign-Body Reaction/pathology , Inguinal Canal/surgery , Organ Size , Polypropylenes , Postoperative Period , Spermatic Cord/surgery , Testis/anatomy & histology , Testosterone/blood , Vas Deferens/surgery , Foreign-Body Reaction/blood , Rats, Wistar , Models, Animal
6.
Chinese Journal of Medical Imaging Technology ; (12): 579-583, 2020.
Article in Chinese | WPRIM | ID: wpr-861061

ABSTRACT

Objective: To explore the value of scrotal ultrasonography for choice of treatment of obstructive azoospermia. Methods: Totally 93 obstructive azoospermia patients were prospectively collected for scrotal ultrasound to evaluate whether the epididymis and vas deferens were intact, dilated or calcified. The diameter of epididymal duct and vas deferens were measured. Then the patients were divided into sperm extraction group (n=27) or vasal reconstruction group (n=66) according to the treatment. The etiology and sonographic appearances were compared between groups. The cut-off values of ultrasonic parameters were evaluated by ROC curve, followed by the sensitivity, specificity, positive predicative value, negative predicative value and accuracy. Results: There were significant differences of epididymal morphology, vas deferens dysplasia, calcification, and the diameter of epididymal duct between 2 groups (all P<0.05). Taken 0.55 mm for the cut-off value of diameter of epididymal duct, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of correctly identifying the patients suitable for sperm extraction was 87.47%, 86.70%, 77.82%, 92.76% and 87.03%, respectively. Conclusion: Scrotal ultrasonography plays an important role in guiding treatment for patients with obstructive azoospermia.

7.
National Journal of Andrology ; (12): 911-916, 2020.
Article in Chinese | WPRIM | ID: wpr-880291

ABSTRACT

Objective@#To explore the diagnosis, classification and treatment of ectopic seminal tract opening in enlarged prostatic utricle (EPU).@*METHODS@#We retrospectively analyzed the clinical data on 22 cases of ectopic seminal tract opening in EPU confirmed by spermography, EPU open cannula angiography or intraoperative puncture of the vas deferens and treated by transurethral incision of EPU, cold-knife incision or electric incision of EPU, full drainage of the anteriorwal, and open or laparoscopic surgery from October 1985 to October 2017.@*RESULTS@#Five of the patients were diagnosed with ectopic opening of the vas deferens and the other 17 with ectopic opening of the ejaculatory duct in EPU. During the 3-48 months of postoperative follow-up, symptoms disappeared in all the cases, semen quality was improved in those with infertility, and 2 of the infertile patients achieved pregnancy via ICSI.@*CONCLUSIONS@#Ectopic seminal tract opening in EPU is rare clinically. Spermography is a reliable method for the diagnosis of the disease, and its treatment should be aimed at restoring the smooth flow of semen based on proper classification and typing of the disease.


Subject(s)
Humans , Male , Ejaculatory Ducts/surgery , Male Urogenital Diseases/surgery , Prostate/surgery , Retrospective Studies , Semen Analysis , Seminal Vesicles/surgery , Vas Deferens/surgery
8.
Asian Journal of Andrology ; (6): 287-291, 2020.
Article in Chinese | WPRIM | ID: wpr-842463

ABSTRACT

Ectopic seminal tract opening is a rare congenital malformation. Until recently, there has been a lack of comprehensive reporting on the condition. The purpose of this retrospective study is to summarize the experience of diagnosis and treatment of this condition based on 28 clinical practice cases throughout the past 30 years. We conducted auxiliary examinations on such patients including routine tests, imaging examinations, and endoscopy. Among these 28 cases, there were ectopic opening of vas deferens into enlarged prostatic utricles (6 cases); ejaculatory ducts into enlarged prostatic utricles, Müllerian ducts cysts, and urethras (18 cases, 2 cases, and 1 case, respectively); and ectopic opening of the unilateral vas deferens and the contralateral ejaculatory duct into enlarged prostatic utricle (1 case). The size of the enlarged prostatic utricle, the type of ectopic seminal tract opening, and the opening's location effectively assisted in the selection of clinical treatment methods, including transurethral fenestration of the utricle, transurethral cold-knife incision, open operation, laparoscopic operation, and conservative treatment. Satisfactory effect was achieved during follow-up. In conclusion, a definite diagnosis and personalized treatment are especially important for patients with ectopic seminal tract opening.

9.
Int. braz. j. urol ; 45(6): 1204-1208, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1056338

ABSTRACT

ABSTRACT Purpose: This study aims to assess the association between CHA2DS2-VASc score and erectile dysfunction in patients who were admitted to cardiology outpatient clinics. Materials and methods: One hundred and two male patients who were admitted to the cardiology outpatient clinic were included to the study. Erectile dysfunction was evaluated in the urology outpatient clinic in the same hospital and scored using Turkish Version of The International Index of Erectile Function. CHA2DS2-VASc score was calculated for every patient using the current associated guidelines. Results: There was a negative correlation between The International Index of Erectile Function score and CHA2DS2-VASc score, age, hypertension, heart failure, diabetes mellitus, stroke respectively. Smoking and dislipidemia were not correlated with The International Index of Erectile Function score (p>0.05). Conclusion: CHA2DS2-VASc score can be used to detect Erectile dysfunction in patients who are admitted to the cardiology outpatient clinics.


Subject(s)
Humans , Male , Adult , Aged , Risk Assessment/methods , Erectile Dysfunction/diagnosis , Erectile Dysfunction/physiopathology , Reference Values , Anthropometry , Cross-Sectional Studies , Reproducibility of Results , Risk Factors , Age Factors , Statistics, Nonparametric , Stroke/physiopathology , Diabetes Mellitus/physiopathology , Heart Failure/physiopathology , Hypertension/physiopathology , Middle Aged
10.
Int. j. morphol ; 37(3): 861-866, Sept. 2019. tab
Article in English | LILACS | ID: biblio-1012366

ABSTRACT

It is important to know the morphological changes that occur in the spermatozoa of rooster during their passage through the reproductive tract, which help to understand what they acquire their fertilization capacity. The morphophysiological changes related to the capacitation and acrosomal reaction processes in the different segments of the rooster reproductive system were analyzed. Samples were obtained from various regions of the rooster reproductive tract and dorso-ventral massage to obtain ejaculates, 25 roosters were used Rhode Island Red with proven fertility, assessments were performed with chlortetracycline and Lectin WGA-FITC to determine the morphophysiological parameters. Sperm motility increases (p<0.05) during the passage of spermatozoa from the testis until they are ejaculated. The parameters of viability and morphology also show differences (p<0.05) in the different segments of the tract. Sperm morphometry shows a spermatic contraction (p<0.05) in the cranial and medial segments of the vas deferens. The acrosomal reaction capacity evaluated with chlortetracycline (CTC) or Wheat germ agglutinin (WGA), was evident increasing the parameters (p<0.05) with the use of the perivitelline layer in the spermatozoa of the reproductive tract and of the ejaculate. Spermatozoa of the reproductive tract of the rooster demonstrate acrosomal reaction capacity without requiring a previous sperm capacitation condition. On the other hand, they do not show parameters of incapacity, which implies that they cannot be stored in any segment of the reproductive tract.


Es importante conocer los cambios morfológicos que se producen en los espermatozoides del gallo durante su paso por el tracto reproductivo y que ayudan a comprender como adquieren su capacidad de fertilización. Se analizaron cambios morfofisiológicos relacionados con los procesos de capacitación y reacción acrosomal de los espermatozoides presentes en los diferentes segmentos del tracto reproductor del gallo. Se obtuvieron espermatozoides de diferentes regiones del tracto reproductor del gallo y de espermatozoides de eyaculado. Se usaron 25 gallos Rhode Island Red con fertilidad probada. Se realizaron evaluaciones básicas, con clortetraciclina (CTC) y lectina Wheat germ agglutinin conjugada con isotiosionato de fluoresceína (WGA-FITC) para determinar los parámetros morfofisiológicos. La motilidad del esperma aumenta (P<0,05) durante el paso de los espermatozoides desde el testículo hasta que son eyaculados. Los parámetros de viabilidad y morfología también muestran diferencias (P <0,05) en los diferentes segmentos del tracto. La morfometría mostró una contracción de los espermatozoides (P<0,05) en los segmentos craneal y medial del conducto deferente. La capacidad de reacción acrosomal evaluada con clortetraciclina CTC o WGAFITC, fue evidente al aumentar los parámetros (P<0,05) con el uso de membrana perivitelina en los espermatozoides del tracto reproductivo y del eyaculado. los espermatozoides del tracto reproductivo del gallo demuestran capacidad de reacción acrosomal sin requerir una condición previa de capacitación espermática. Por otro lado, no muestran parámetros de descapacitación espermática lo que implica que no pueden almacenar en ningún segmento del tracto reproductivo.


Subject(s)
Animals , Male , Spermatozoa , Chickens/anatomy & histology , Genitalia, Male/anatomy & histology , Semen , Sperm Motility , Vas Deferens/anatomy & histology , Acrosome , Fertility
11.
Int. braz. j. urol ; 45(5): 1013-1019, Sept.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040073

ABSTRACT

ABSTRACT Objectives To validate an experimental non-animal model for training of vasectomy reversal. Materials and Methods The model consisted of two artificial vas deferens, made with silicon tubes, covered by a white resin, measuring 10 cm (length) and internal and external diameters of 0.5 and 1.5 mm, respectively. The holder of the ducts is made by a small box developed with polylactic acid, using a 3D print. The objective of the invention is to simulate the surgical field of vasovasostomy, when the vas deferens are isolated from other cord structures. For validation, it was verified the acquisition of microsurgical skills during its use, in a capacitation course with 5 urology residents from a Hospital of the region. Along the training sessions, it was analyzed the time (speed) of microsurgical sutures, and quantification of the performance using a checklist. Collected data were analyzed using de BioEstat®5.4 software. Results Medium time for the completion of microsurgical sutures improved considerably during the course, and reached a plateau after the third day of training (p=0.0365). In relation to the checklist, it was verified that during capacitation, there was significant improvement of the scores of each participant, that reached a plateau after the fourth day of training with the model (p=0.0035). Conclusion The developed model was able to allow the students that attended the course to gain skills in microsurgery, being considered appropriate for training vasectomy reversal.


Subject(s)
Humans , Male , Vasovasostomy/education , Models, Anatomic , Silicon , Time Factors , Vas Deferens/surgery , Reproducibility of Results , Analysis of Variance , Clinical Competence , Statistics, Nonparametric , Checklist , Printing, Three-Dimensional , Microsurgery/education
12.
National Journal of Andrology ; (12): 231-237, 2019.
Article in Chinese | WPRIM | ID: wpr-816805

ABSTRACT

Objective@#To investigate the association between the 5T site polymorphism of the cystic fibrosis transmembrane conductance regulator (CFTR) gene and the risk of congenital bilateral absence of the vas deferens (CBAVD).@*METHODS@#This case-control study included 40 male patients with isolated CBAVD in the experimental group and 104 healthy men as controls. We used the Sanger sequencing method to encode the CFTR gene intron 9 (TG) m-n(T) and type the haplotypes, followed by a review and meta-analysis of the data obtained from the experiment and relevant literature from the PubMed, Web of science, Medline, CNKI and an exploration of the correlation between 5T mutation and the risk of CBAVD.@*RESULTS@#Sanger sequencing revealed 6 genotypes in the CBAVD patients, including TG11-5T, TG12-5T, TG13-5T, TG11-7T, TG12-7T and TG11-9T, and 7 in the healthy controls, which were TG11-5T, TG12-5T, TG10-7T, TG11-7T, TG12-7T, TG13-7T and TG11-9T. Compared with the controls, the CBAVD patients showed obviously increased rates of the TG12-5T haplotype (4.81% [10/208] vs 16.25% [13/80]) and the TG13-5T haplotype (0% vs 7.5% [6/80]), but no significant difference in the TG11-5T haplotype (1.92% [4/208] vs 2.50% [2/80]). There was a statistically significant difference between the experimental and control groups in the TG12_13-5T haplotype (OR = 7.40, 95% CI: 4.83-11.34, P < 0.01). The TG12_13-5T haplotype was found to be highly correlated with CBAVD.@*CONCLUSIONS@#The haplotype of TG12_13-5T increases the risk of CBAVD in men, which has provided a theoretical basis for male reproduction.

13.
Int. braz. j. urol ; 44(1): 192-195, Jan.-Feb. 2018. graf
Article in English | LILACS | ID: biblio-892936

ABSTRACT

ABSTRACT The biochemical recurrence after local treatment for prostate cancer is an often challenging condition of clinical management. The aim of this report is to demonstrate the importance of the association of various imaging methods in the identification and subsequent accurate percutaneous biopsy in patients with recurrence of prostate cancer, especially in unusual sites. An 86 years old male with biochemical recurrence, during radiological investigation a PET-MRI was noted the presence of an asymmetry of the vas deferens with PSMA-68Ga uptaken, suggesting the recurrence. A percutaneous fusion biopsy with PET-MRI and ultrasound was performed using transrectal access using ultrasound confirming infiltrating adenocarcinoma of the wall of the vas deferens, compatible with neoplastic prostate recurrence. The fusion image technique combines the real-time view of the US to the possibility of higher definition and higher specificity, methods more anatomical detail as tomography and magnetic resonance imaging, simultaneously. High resolution acquired in PET / MR associated with image fusion allows orientation procedures, even in areas of difficult access, with greater accuracy than conventional techniques.


Subject(s)
Humans , Male , Aged , Prostatic Neoplasms/diagnostic imaging , Adenocarcinoma/diagnostic imaging , Ultrasonography, Interventional/methods , Image-Guided Biopsy/methods , Neoplasm Recurrence, Local/diagnostic imaging , Prostatectomy , Prostatic Neoplasms/surgery , Prostatic Neoplasms/pathology , Magnetic Resonance Imaging , Adenocarcinoma/surgery , Adenocarcinoma/pathology , Tomography, X-Ray Computed , Ultrasonography , Neoplasm Recurrence, Local/surgery , Neoplasm Recurrence, Local/pathology
14.
Int. braz. j. urol ; 44(1): 188-191, Jan.-Feb. 2018.
Article in English | LILACS | ID: biblio-892938

ABSTRACT

ABSTRACT Objectives To describe the retrieval spermatozoa technique for cryopreservation after death, including the proximal part of vas deferens. Material and Methods A 28-years old man, with previous history of infertility, who had died 12 hours before, was submitted to spermatozoa retrieval for cryopreservation, with surgical bilateral resection in bloc of the proximal part of vas deferens, testicle and epididymis. At the laboratory, by milking the epididymis and vas deferens, the extracted fluid was collected; also, three samples of each testicle parenchyma were also harvested. Results The fluid from the vas deferens showed spermatozoa, mostly with in situ motility. Testicular fragments also presented spermatozoa, mostly with small tail movements or immobile. Conclusion The inclusion of the proximal part of vas deferens during spermatozoa retrieval after death must be performed, since it contains high concentration of spermatozoa, and even in the presence of previous infertility, as was with this patient, it is possible to retrieve spermatozoa.


Subject(s)
Humans , Male , Adult , Semen Preservation/methods , Cryopreservation , Sperm Retrieval , Sperm Motility , Vas Deferens , Epididymis
15.
Article in English | IMSEAR | ID: sea-178747

ABSTRACT

Background & objectives: The role of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in congenital bilateral absence of vas deferens and unilateral renal agenesis (CBAVD-URA) has been controversial. Here, we report the cases of five Indian males with CBAVD-URA. The objective was to evaluate the presence or absence of CFTR gene mutations and variants in CBAVD-URA. The female partners of these males were also screened for cystic fibrosis (CF) carrier status. Methods: Direct DNA sequencing of CFTR gene was carried out in five Indian infertile males having CBAVD-URA. Female partners (n=5) and healthy controls (n=32) were also screened. Results: Three potential regulatory CFTR gene variants (c.1540A>G, c.2694T>G and c.4521G>A) were detected along with IVS8-5T mutation in three infertile males with CBAVD-URA. Five novel CFTR gene variants (c.621+91A>G, c.2752+106A>T, c.2751+85_88delTA, c.3120+529InsC and c.4375-69C>T), four potential regulatory CFTR gene variants (M470V, T854T, P1290P, Q1463Q) and seven previously reported CFTR gene variants (c.196+12T>C, c.875+40A>G, c.3041-71G>C, c.3271+42A>T, c.3272-93T>C, c.3500-140A>C and c.3601-65C>A) were detected in infertile men having CBAVD and renal anomalies Interpretation & conclusions: Based on our findings, we speculate that CBAVD-URA may also be attributed to CFTR gene mutations and can be considered as CFTR-related disorder (CFTR-RD). The CFTR gene mutation screening may be offered to CBAVD-URA men and their female partners undergoing ICSI. Further studies need to be done in a large sample to confirm the findings.

16.
Anatomy & Cell Biology ; : 231-240, 2016.
Article in English | WPRIM | ID: wpr-225096

ABSTRACT

Because the ureter arises from the mesonephric or Wolffian duct (WD), the WD opening should migrate inferiorly along the urogenital sinus or future urethra. However, this process of descent has not been evaluated morphometrically in previous studies and we know little about intermediate morphologies for the descent. In the present work, serial sagittal sections of 15 specimens at gestational age 6–12 weeks and serial horizontal sections of 20 specimens at 6–10 weeks were analyzed. Monitoring of horizontal sections showed that, until 9 weeks, a heart-, lozenge- or oval-shape of the initial urogenital sinus remained in the bladder and urethra. Thus, the future bladder and urethra could not be distinguished by the transverse section or plane. The maximum width of the urogenital sinus or bladder at 6–10 weeks was 0.8 mm, although its supero-inferior length reached 5 mm at 10 weeks. During earlier stages, however, the medial shift of the WD was rather evident. Depending on the extent of upward growth of the bladder smooth muscle, the descent of the vas deferens became evident at 10–12 weeks. Development of the urethral rhabdosphincter likely resulted in the differentiation of urogenital sinus into the urethra and bladder before formation of the bladder neck with 3-layered smooth muscles. Development of the prostate followed these morphological changes, later accelerating the further descent of the WD opening. Because of their close topographical relationships, slight anomalies or accidents of the umbilical cord at 10–12 weeks may have a significant effect on normal anatomy.


Subject(s)
Humans , Embryonic Structures , Fetus , Gestational Age , Human Development , Muscle, Smooth , Neck , Prostate , Umbilical Cord , Ureter , Urethra , Urinary Bladder , Vas Deferens , Wolffian Ducts
17.
Asian Journal of Andrology ; (6): 365-371, 2016.
Article in Chinese | WPRIM | ID: wpr-842894

ABSTRACT

Vasectomy is a safe and effective method of contraception used by 42-60 million men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Interest in this procedure has increased since the operating microscope became available in the 1970s, which consequently led to improved patency and pregnancy rates following the procedure. In this clinical update, we discuss patient evaluation, variables that may influence reversal success rates, factors to consider in choosing to perform vasovasostomy versus vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate postvasectomy pain syndrome. We also review the use of robotics for vasectomy reversal and other novel techniques and instrumentation that have emerged in recent years to aid in the success of this surgery.

18.
Acta cir. bras ; 29(8): 499-507, 08/2014. tab, graf
Article in English | LILACS | ID: lil-719185

ABSTRACT

PURPOSE: To determine whether tension in the spermatic cord of rats causes lesions in the testis, epididymis or vas deferens. METHODS: Forty Wistar rats were randomly allocated into four groups. A traction force of 1.6 Newton (N) in group I and 1 N in group II was applied to the right spermatic cord. Group III was the sham, and group IV served as the control. RESULTS: Testicular lesions occurred on the right side in 66.7% of the rats and on the left side in 46.1% of the rats. The testes showed a decreased number of Sertoli cells, necrosis and a decreased number of germ cells in the seminiferous tubules. Anatomopathological changes in the vas deferens were not identified. There was no decrease in the thickness of the muscle wall of the vas deferens. In the right epididymis, 71.8% of the animals showed a reduction and 5% showed an absence of intraluminal sperm. In the left epididymis, 37.5% of the rats showed a reduction. The volume and the final testicular weight of the right side in group IV was different from those in the other groups. CONCLUSIONS: Anatomopathological lesions were found in the testis and epididymis. .


Subject(s)
Animals , Male , Spermatic Cord/pathology , Traction/adverse effects , Epididymis/injuries , Epididymis/pathology , Models, Animal , Necrosis/etiology , Organ Size , Rats, Wistar , Seminiferous Tubules/pathology , Spermatic Cord/injuries , Testis/injuries , Testis/pathology , Vas Deferens/pathology
19.
Biota neotrop. (Online, Ed. port.) ; 14(3): 1-5, 29/08/2014. tab, graf
Article in English | LILACS | ID: lil-720411

ABSTRACT

This study aimed to characterize the morphology of the vas deferens of Kinosteron scorpioides by macroscopic and microscopic analysis. Were used 20 adult male jurarás collected at regular intervals during the year and divided into four experimental groups in the rainy and dry seasons, being processed for light microscopy, scanning electron microscopy and transmission electron microscopy. Morphometry for tubular and luminal diameters and epithelial height were also performed. On rainy season, vas deferens presented pseudostratified epithelium with cylindrical cells, spermatozoids and milky fluid in the lumen, with cytoplasmic organelles and lipid vesicles. On dry season, epithelium was pseudostratified with cuboid cells, with cellular debris and no spermatozoids. There was significant variation (p<0,05) for morphometry of vas deferens, with lower values of tubular and luminal diameters on rainy season, and higher epithelial height on dry season.


Este estudo teve como objetivo caracterizar a morfologia dos ductos deferentes de Kinosteron scorpioides por meio de análise macroscópica e microscópica. Foram utilizados 20 machos adultos, coletados em intervalos regulares durante o ano, os quais foram divididos em quatro grupos experimentais nas estações chuvosa e seca. Os ductos deferentes foram processados para análise por microscopia de luz, microscopia eletrônica de varredura e microscopia eletrônica de transmissão. Morfometria para diâmetros tubular e luminal e altura epitelial também foram realizadas. Na época das chuvas, o ducto deferente apresentou epitélio pseudoestratificado com células cilíndricas, espermatozoides e líquido leitoso no lúmen, além de com organelas citoplasmáticas e vesículas lipídicas. Na estação seca, o epitélio do ducto deferente foi do tipo pseudoestratificado com células cuboides e debris celulares, sendo que nenhum espermatozoide foi encontrado nesta estação. Houve variação significativa (p <0,05) para a morfometria dos ductos deferentes, com menores valores de diâmetros tubular e luminal na estação chuvosa, e maior altura do epitélio na estação seca.

20.
Int. braz. j. urol ; 39(5): 720-726, Sep-Oct/2013. tab
Article in English | LILACS | ID: lil-695154

ABSTRACT

Objectives Evaluation of the presence of spermatozoa in vas deferens fluid after a long interval of unilateral and homolateral percutaneous epididymal sperm aspiration (PESA) in vasectomized men. When found, the spermatozoa were evaluated including concentration and motility, in order to verify the patency of the epididymal tubules. Materials and Methods Four patients, numbered in a progressive order, from one to four, with 38, 40, 48 and 51 years old and vasectomy interval of 10, 10, 25 and 11 years, respectively, whose wives did not get pregnant using intracytoplasmic sperm injection of sperm obtained by unilateral PESA and decided to try only natural conception, were submitted to intrasurgical sperm analysis of the vas deferens fluid (ISAVDF) during microsurgery for reconstruction of the seminal tract. Results Time interval between PESA and ISAVDF was 13.75 ± 11.12 months (x ± s) varying from 3 to 29 months. Homolateral ISAVDF and PESA showed the presence of spermatozoa. Patients 1, 2 and 4 had a high concentration of 10 x 106, 64 x 106 and 45 x 106 spermatozoa/ mL; the first two had motile sperms and patient 3 had no sperms. Conclusions Three of four patients showed spermatozoa in the vas deferens fluid after a long interval of unilateral and homolateral PESA with high concentration, including motile forms. These findings support the concept that PESA may not result in late epipidymal tubule obstruction in vasectomized patients. .


Subject(s)
Adult , Humans , Male , Middle Aged , Epididymis/surgery , Sperm Retrieval , Spermatozoa , Vas Deferens/surgery , Vasovasostomy/methods , Azoospermia , Microsurgery , Reproducibility of Results , Sperm Count , Sperm Motility , Time Factors , Treatment Outcome , Vasectomy
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