Congenital Agenesis of the Vas Deferens

Choi, Byoung Gi; Lee, Hee Yong

Abstract

Thirty three patients with congenital agenesis of the vas deferens were investigated in Seoul National University Hospital for the past 10 years. These patients correspond to 2.4% of 1,398 infertile males and 14.8% of 223 azoospermic patients due to epididymal obstruction. These anomalies were confirmed by surgical explorations, They were consisted of 24 patients with bilateral agenesis of the vas deferens and 9 patients with unilateral agenesis(5 in right side, 4 in left side). Type 2 anomaly, vas agenesis without defects of epididymis, was found in 25(44%) of a total of 57 anomalies of the vas deferens. Type 1 anomaly, vas agenesis with defects on body or tail of epididymis, was found in 21(37%), and type 3 in which the head of epididymis and distal vas are identified but body and tail of epididymis and proximal vas are absent, was found in 11(19%). The histological examination of the testis showed normal spermatogenesis in the most of the patients, The seminal volume was reduced in 24 patients, and normal in 9 patients. The seminal fructose was reduced in 13 patients. It is suggested that vas agenesis would be associated with the absence of seminal vesicle in patients with reduced seminal volume and reduced seminal fructose level. In seven patients with unilateral agenesis of the vas deferens, the obstructive lesions of epididymal tails of contralateral side were corrected by epididymovasostomy under surgical microscope. The results were successful in 2 patients. In three patients with bilateral agenesis of the vas deferens of type 3, epididymovasostomy could be performed. Successful results were obtained in 2 patients. In conclusion, the results of this clinical investigation emphasize the importance of careful scrotal examination in the diagnosis of an infertile males and in the preparative examination of vasectomy operation.