ULTRASTRUCTURAL-CHANGES IN THE EFFERENT DUCT AND EPIDIDYMIS OF MEN WITH OBSTRUCTIVE INFERTILITY

Ultrastructural changes in the efferent duct and in different regions of the epididymis in men with obstructive azoospermia were compared wi th corresponding tissues collected from men of proven fertility who un derwent castration due to malignancy of the prostate. Major degenerati ve changes were seen in the efferent duct and the caput epididymidis o f men with obstruction at the caput epididymidis which may have been i nduced by fluid pressure due to defective absorption of testicular flu id in the caput epididymidis. These degenerative changes included decr ease in tubular and lumen diameter of the caput and the cauda epididym ides, decrease in height of the stereocilia, reduction in rough endopl asmic reticulum and Golgi material, and presence of lipofuscin and osm iophilic dense bodies. The degenerative changes were less when the sit e of obstruction was in the cauda epididymidis since fluid reabsorptio n would continue to take place normally in the caput epididymidis. In men who had undergone vasoepididymostomy (VEA), the ejaculated spermat ozoa showed a high percentage of morphological abnormalities which may have occurred due to adverse effects of long-term obstruction on sper matogenesis. (C) 1993 Wiley-Liss, Inc.