EPIDIDYMAL AND VASAL ABNORMALITIES IN UNDESCENDED TESTES AND AZOOSPERMIA

Epididymal and vasal abnormalities (EVA) have long been known to be as sociated with cryptorchidism. In order to provide data concerning the incidence of EVA in undescended testicles, ute operatively examined th e anatomic relationship of the epididymis, vas, and testis in 456 cryp torchid patients (390 unilateral and 66 bilateral, over all 522 undesc ended testes). As a control group we examined 50 adults postmortem and 96 pediatric patients operated upon for inguinal hernia or hydrocele. We divided the operative findings into two groups: simple variants of normal, and forms of complete anatomic disconnection of the spermatic ducts. We were unable to find any anatomic disconnection in either co ntrol group. In contrast, in 99 of the 522 maldescended testes operate d upon (19%) we found some form of anatomic disconnection along the pr oximal spermatic ducts. The incidence was 17% in unilateral cryptorchi dism and 26% in bilateral cases, in 16% of whom the EVA was bilateral. According to the literature and our previous study, azoospermia is pr esent in about 18% -20% of adults operated upon for bilateral cryptorc hidism. Our present study may suggest that in bilateral cryptorchid pa tients who were operated upon in the pediatric age range, the azoosper mia in adulthood could be partially related to some form of bilateral occlusion or interruption of the spermatic ducts.