Blocked vas deferens

Introduction Sperm discharge must pass through the testicular output tube, epididymis tube, vas deferens, ejaculatory duct and part of the urethra. Blockage of any of the above can affect sperm discharge. The unilateral insemination pipeline is blocked, which has little effect on fertility. When the bilateral side is blocked, the sperm cannot be discharged normally, which will lead to infertility. Obstruction of the vas deferens can cause obstructive azoospermia, also known as pseudo-azoospermia. Its clinical manifestations are normal testicular size, no sperm, blood follicle stimulating hormone (FSH) and normal testosterone levels, testicular biopsy The result is normal.

Cause

Common causes of obstruction of the vas deferens

There are several common causes of blockage of the insemination pipeline:

1) Infection of the genitourinary system: such as epididymitis, prostatitis, seminal vesiculitis or epididymal vas deferens tuberculosis, etc., causing obstruction of the vas deferens, and the connection between the epididymis and the vas deferens is more common.

2) Injury: such as hernia repair, varicocele, spermatic cord surgery, etc. can damage the vas deferens, epididymal semen cyst, testicular hydrocele surgery, can damage the epididymis, prostate surgery can cause ejaculation orifice occlusion, or Although there is no direct damage, postoperative infection and adhesion scar formation can cause compression and obstruction of the insemination pipeline.

3) Tumors: such as epididymal tumors, seminal vesicle tumors, prostate tumors, etc., can cause obstruction of the insemination pipeline.

4) Congenital malformations: such as absence of the epididymis head, body, tail segment, vaginal canal or a complete absence, vas deferens and epididymis are not connected, epididymis, vas deferens or seminal vesicle hypoplasia.

an examination

Related inspection

Vas deferens angiography X-ray examination of scrotal ultrasound

Semen analysis

No sperm was determined by three or more semen analysis and centrifugal sedimentation examination. At the same time pay attention to the amount of semen, sperm count, sperm motility, semen pH, viscosity and so on.

2. Seminal plasma biochemical detection

Seminal plasma consists of testicular fluid, epididymal fluid, prostatic fluid, and paraurethral gland secretions. The determination of the biochemical components of seminal plasma can understand the function of the accessory gonads, and provide a basis for the differential diagnosis of azoospermia and the location of vas deferens obstruction. Including the examination of fructose, neutral alpha glycosidase, prostate D synthase, and inhibin B.

3. Ultrasound

Transrectal ultrasound can measure the axial and sagittal diameters of the vas deferens, seminal vesicles, ejaculatory ducts and prostate, and observe the internal structure. It is of special significance for the identification of congenital dysplasia and ejaculatory duct obstruction. Doppler ultrasound can locate the spermatozoa of the testicular puncture according to the distribution of blood vessels in the testis.

4. Genetic examination

In patients with azoospermia, there are chromosomal abnormalities, and chromosomes are routinely tested in patients with azoospermia.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Male friends with a lot of pain in the vas deferens have found that there is pain in the vas deferens, so they are concerned about the cause of vas deferens pain. In general, vas deferens pain occurs, and only through some related examinations can the cause be determined.

2. The thickening of the vas deferens and the thickening of the vas deferens is one of the clinical manifestations of varicocele. The varicocele refers to the expansion of the veins in the spermatic cord due to obstruction of the reflux. It is a common disease in young and middle-aged people. It refers to the vasodilatation, distortion and lengthening of the spermatic plexus (venous vascular plexus) caused by the accumulation of spermatic vein blood flow. The incidence rate is 10-15% for males and 15-20% for male infertility. This disease occurs mostly on the left side, but it is not uncommon for both sides to develop, which can be as high as 20%.

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