The presence of vasal vessels in men with congenital bilateral absence of the vas deferens

Jay Raman, Marc Goldstein

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: We characterized spermatic cord microanatomy in men with congenital bilateral absence of the vas deferens (CBAVD) presenting for varicocelectomy. We discuss the implications of these findings for varicocele repair. Materials and Methods: Between 1997 and 2003, 8 men with CBAVD underwent a total of 11 microsurgical subinguinal varicocelectomies at microsurgical epididymal sperm aspiration and cryopreservation. All 8 men had palpable grades II to III varicoceles and in 6 varicoceles were repaired due to painful symptomatology, while 2 had testicular hypotrophy with an abnormal hormonal profile. Three men had bilateral varicoceles repaired, while 5 underwent unilateral varicocelectomy. All patients provided a thorough history and underwent physical examination, hormonal evaluation, semen analysis, genetic testing and renal ultrasonography. Results: Intraoperative microsurgical dissection confirmed dilated internal and external spermatic veins, and absence of the vas deferens in all 11 spermatic cords. Characteristic tortuous vasal vessels of normal caliber were clearly identified in all 11 (100%) of these spermatic cords between the internal and external spermatic fasciae in the location where the vas deferens is usually found. Conclusions: Despite the absence of the vas deferens normal sized, orthotopically located vasal vessels were present in 100% of the spermatic cords examined. Furthermore, the caliber of the vasal veins was sufficient to provide adequate venous return from the testis following ligation of the internal and external spermatic veins. In patients with CBAVD presenting for varicocele repair standard microsurgical varicocelectomy with ligation of all internal and external spermatic veins can be performed without the risk of testicular congestion secondary to inadequate venous drainage.

Original languageEnglish (US)
Pages (from-to)1941-1943
Number of pages3
JournalJournal of Urology
Volume172
Issue number5 I
DOIs
StatePublished - Jan 1 2004

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Varicocele
Spermatic Cord
Spermatozoa
Veins
Ligation
Sperm Retrieval
Semen Analysis
Vas Deferens
Fascia
Cryopreservation
Genetic Testing
Physical Examination
Testis
Dissection
Drainage
Ultrasonography
History
Congenital bilateral aplasia of vas deferens
Kidney

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

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title = "The presence of vasal vessels in men with congenital bilateral absence of the vas deferens",
abstract = "Purpose: We characterized spermatic cord microanatomy in men with congenital bilateral absence of the vas deferens (CBAVD) presenting for varicocelectomy. We discuss the implications of these findings for varicocele repair. Materials and Methods: Between 1997 and 2003, 8 men with CBAVD underwent a total of 11 microsurgical subinguinal varicocelectomies at microsurgical epididymal sperm aspiration and cryopreservation. All 8 men had palpable grades II to III varicoceles and in 6 varicoceles were repaired due to painful symptomatology, while 2 had testicular hypotrophy with an abnormal hormonal profile. Three men had bilateral varicoceles repaired, while 5 underwent unilateral varicocelectomy. All patients provided a thorough history and underwent physical examination, hormonal evaluation, semen analysis, genetic testing and renal ultrasonography. Results: Intraoperative microsurgical dissection confirmed dilated internal and external spermatic veins, and absence of the vas deferens in all 11 spermatic cords. Characteristic tortuous vasal vessels of normal caliber were clearly identified in all 11 (100{\%}) of these spermatic cords between the internal and external spermatic fasciae in the location where the vas deferens is usually found. Conclusions: Despite the absence of the vas deferens normal sized, orthotopically located vasal vessels were present in 100{\%} of the spermatic cords examined. Furthermore, the caliber of the vasal veins was sufficient to provide adequate venous return from the testis following ligation of the internal and external spermatic veins. In patients with CBAVD presenting for varicocele repair standard microsurgical varicocelectomy with ligation of all internal and external spermatic veins can be performed without the risk of testicular congestion secondary to inadequate venous drainage.",
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The presence of vasal vessels in men with congenital bilateral absence of the vas deferens. / Raman, Jay; Goldstein, Marc.

In: Journal of Urology, Vol. 172, No. 5 I, 01.01.2004, p. 1941-1943.

Research output: Contribution to journalArticle

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AU - Goldstein, Marc

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N2 - Purpose: We characterized spermatic cord microanatomy in men with congenital bilateral absence of the vas deferens (CBAVD) presenting for varicocelectomy. We discuss the implications of these findings for varicocele repair. Materials and Methods: Between 1997 and 2003, 8 men with CBAVD underwent a total of 11 microsurgical subinguinal varicocelectomies at microsurgical epididymal sperm aspiration and cryopreservation. All 8 men had palpable grades II to III varicoceles and in 6 varicoceles were repaired due to painful symptomatology, while 2 had testicular hypotrophy with an abnormal hormonal profile. Three men had bilateral varicoceles repaired, while 5 underwent unilateral varicocelectomy. All patients provided a thorough history and underwent physical examination, hormonal evaluation, semen analysis, genetic testing and renal ultrasonography. Results: Intraoperative microsurgical dissection confirmed dilated internal and external spermatic veins, and absence of the vas deferens in all 11 spermatic cords. Characteristic tortuous vasal vessels of normal caliber were clearly identified in all 11 (100%) of these spermatic cords between the internal and external spermatic fasciae in the location where the vas deferens is usually found. Conclusions: Despite the absence of the vas deferens normal sized, orthotopically located vasal vessels were present in 100% of the spermatic cords examined. Furthermore, the caliber of the vasal veins was sufficient to provide adequate venous return from the testis following ligation of the internal and external spermatic veins. In patients with CBAVD presenting for varicocele repair standard microsurgical varicocelectomy with ligation of all internal and external spermatic veins can be performed without the risk of testicular congestion secondary to inadequate venous drainage.

AB - Purpose: We characterized spermatic cord microanatomy in men with congenital bilateral absence of the vas deferens (CBAVD) presenting for varicocelectomy. We discuss the implications of these findings for varicocele repair. Materials and Methods: Between 1997 and 2003, 8 men with CBAVD underwent a total of 11 microsurgical subinguinal varicocelectomies at microsurgical epididymal sperm aspiration and cryopreservation. All 8 men had palpable grades II to III varicoceles and in 6 varicoceles were repaired due to painful symptomatology, while 2 had testicular hypotrophy with an abnormal hormonal profile. Three men had bilateral varicoceles repaired, while 5 underwent unilateral varicocelectomy. All patients provided a thorough history and underwent physical examination, hormonal evaluation, semen analysis, genetic testing and renal ultrasonography. Results: Intraoperative microsurgical dissection confirmed dilated internal and external spermatic veins, and absence of the vas deferens in all 11 spermatic cords. Characteristic tortuous vasal vessels of normal caliber were clearly identified in all 11 (100%) of these spermatic cords between the internal and external spermatic fasciae in the location where the vas deferens is usually found. Conclusions: Despite the absence of the vas deferens normal sized, orthotopically located vasal vessels were present in 100% of the spermatic cords examined. Furthermore, the caliber of the vasal veins was sufficient to provide adequate venous return from the testis following ligation of the internal and external spermatic veins. In patients with CBAVD presenting for varicocele repair standard microsurgical varicocelectomy with ligation of all internal and external spermatic veins can be performed without the risk of testicular congestion secondary to inadequate venous drainage.

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