Intra-abdominal vas deferens cyst in a laboratory rhesus macaque (Macaca mulatta).

A 21-year-old male rhesus macaque presented with abdominal enlargement. The clinical, magnetic resonance imaging, and computerized tomography findings confirmed a large mass occupying the entire abdomen. The mass was surgically removed, and histopathology confirmed a vas deferens cyst. The macaque recovered uneventfully. The veterinarians should be aware of the possibility of an intra-abdominal vas deferens cyst and that, as our case shows, could be treated with surgical removal.

Ultrasonography and CT of the vas deferens in a neutered male dog with chronic exogenous estrogen exposure.

A 2-year-old male neutered Rat Terrier was presented for alopecia, recurrent urinary tract infections, and urinary incontinence. Abdominal ultrasound and CT identified a thin, tubular, paired structure arising from the craniodorsal aspect of an enlarged, cystic prostate. An atypical uterus masculinus was initially suspected, however it was then identified that the patient had chronic exogenous estrogen exposure, and surgical resection and histopathology was consistent with an enlarged and inflamed vas deferens. Vas deferens enlargement and vasitis secondary to chronic hyperestrogenism should be considered for a tubular, paired structure arising from the craniodorsal prostate in a male dog.

Ultrasound of the Normal and Abnormal Vas Deferens.

ABSTRACT: The extrapelvic portion of the vas deferens is readily visible with ultrasound but often overlooked. Several publications have described the scanning technique and the normal anatomy of the vas deferens. Sonographic evaluation of the vas deferens provides critical information in the workup of male infertility. Obstruction, inflammatory conditions, and neoplasms of the vas deferens can also be diagnosed with ultrasound. Knowledge of the normal and abnormal appearance of the vas deferens improves scans of the scrotum and expands the conditions that can be recognized and accurately diagnosed with ultrasound.

Multiple vas deferens with polyorchidism and many congenital malformations in a symptomatic 11-year-old male patient: a rare case report.

BACKGROUND: Ductus deferens may manifest in a variety of anomalies such as its absence, duplication, ectopy, or diverticulum. Ectopic seminal tract opening has two main types, ectopic ejaculatory duct opening, and ectopic vas deferens opening. Generally, ductus deferens anomalies affect approximately 0.05% of the population. Patients may be asymptomatic or complaining of urinary tract infections and/or epididymitis. Most of these cases are associated with renal dysplasia. To confirm the diagnosis Cystourethroscopy catheterization and retrograde urethrogram should be performed, but the definitive diagnosis is done by vasography. The definitive treatment is complete surgical resection of the pathological urogenital connection. This case is commonly discovered while exploring other findings such as testicular torsion and inguinal hernia. CASE PRESENTATION: We report a rare case of an 11-year-old male who presented with gross hematuria and numerous congenital malformations including a left polydactyly clubfoot, polyorchidism, with several surgical procedures, and left kidney dysgenesis. Surgery was performed for a left inguinal hernia, during which a third undescended testicle was discovered incidentally and was eradicated. A retrograde urethrogram was performed to establish the diagnosis. A fistula- that is connected with the left ureter- was resected. The histopathologic findings confirmed the diagnosis of true duplication of the Vas deferens, with communication between the ureter and the vas deferens. By follow-up, the kidney function tests were within normal limits. CONCLUSIONS: This case report aims to highlight the early diagnosis and management of the duplicated vas deferens and the associated congenital malformations to improve the prognosis and kidney function and to avoid long-term complications.

A cross-sectional study of the genital duct and renal anomalies in Egyptian cases of congenital absence of the vas deferens.

The aim of the study was to detect the incidence and types of genital and renal duct anomalies associated with congenital absent vas deferens (CAVD). In 200 males with CAVD, the demographic characteristics, physical examination findings were evaluated. Scrotal ultrasonography and transrectal ultrasonography (TRUS) were used as the diagnostic methods for evaluating unilateral or bilateral CAVD with associated abnormalities or agenesis of the testes, epididymes, seminal vesicles and prostate. Abdominal ultrasound was performed to detect any associated renal anomalies. There were a total of 111 CBAVD and 89 CUAVD males. Eight cases (8.98%) of CUAVD were associated with contralateral cryptorchidism. In most cases there were agenesis in the epididymal body and tail and seminal vesicles. Different types of renal anomalies (32.50%) especially renal agenesis were observed mainly in cases of left CUAVD and were predominately on the left hand side. An important implication of our study is the importance of requesting ultrasound of males with CAVD to discover any associated anomalies especially renal agenesis that may be ignored by many physicians.

Epididymal Appearance in Congenital Absence of Vas Deferens.

Scrotal sonography was performed in the infertile males. Sonography of epididymis was performed to document its presence, appearance, echo texture and duct ectasia. The spermatic cord was examined to document the status of the vas deferens. TRUS was performed to look for distal vas. Epididymal abnormalities were universal in men with congenital bilateral absence of vas deferens, with a sensitivity of 100%. Three types of abnormal appearances were recognized - a honeycomb appearance, a fine meshwork pattern of head, or complete or partial absence of epididymis. Identification of these abnormalities can be a very sensitive marker for congenital bilateral absence of vas deferens.

Congenital absence of the vas deferens: Cystic fibrosis transmembrane regulatory gene mutations.

Congenital absence of the vas deferens (CAVD) is a rare genetic condition first discovered in the mid-18th century related to mutations in the cystic fibrosis transmembrane regulatory genes. The condition is typically found during work-up of male infertility, and the majority of cases can be diagnosed with complete history and physical examination and pertinent investigations. The condition can be separated into three subcategories, and genetic advances have led to a much better understanding behind the disease, its pathogenesis, and options for treatment. In this review, we discuss the genetics, pathogenesis, embryology, and diagnosis of treatment of CAVD. Future work in this area likely will aim to better understand the epigenetic factors that influence the development of the condition in order to identify potential upstream therapeutic targets.

Prevalence of Vas Deferens Calcifications on Abdominal CT Examinations and Association With Systemic Conditions.

OBJECTIVE. The purpose of this study was to describe the prevalence of vas deferens (VD) calcifications on abdominal CT examinations and the associations between VD calcifications and several systemic conditions. MATERIALS AND METHODS. The CT examinations of male patients from January 2010 to December 2011 were retrospectively reviewed. After exclusions, the records of 1915 consecutively identified patients were analyzed. Five readers, 3rd- and 4th-year radiology residents, recorded the presence and laterality of VD calcifications and of vascular calcifications presumed due to atherosclerosis. A sixth reader parsed the patient records for diagnoses of type 2 diabetes mellitus (DM) and chronic kidney disease (CKD). RESULTS. The mean age of the entire sample population was 52.9 ± 18.9 years (range, 1-93 years). The mean age of patients with VD calcifications was 59.3 ± 12.0 (SD) years and of the group without VD calcifications was 52.9 ± 19.1 years (p = 0.17). The prevalence of VD calcification was 1.61% (31 patients): 21 (67.7%) of the patients had bilateral calcification; seven (22.6%), right-sided only; and three, (9.7%) left-sided. The frequency of DM was 28.8% (551/1915), of CKD was 7.58% (150/1915), and of atherosclerosis, 60.4% (1156/1915). The mean caliber of calcified VDs was 5.31 ± 1.29 mm versus 3.63 ± 0.63 mm for patients without calcification or any chronic condition (p < 0.0001). Among age, atherosclerosis, DM, and CKD in univariate regression analysis, only DM was associated with VD calcification (p = 0.006). However, because age (p = 0.063) and atherosclerosis (p = 0.057) were close to significant, they were included in the multivariate analysis, which also showed only DM associated with VD calcification (odds ratio, 2.14 ± 0.85). CONCLUSION. In the large cohort in this study, the prevalence of VD calcification was 1.61%. VD calcification was strongly associated with DM. The pathologic implications of VD calcification remain unclear and warrant further investigation in prospective longitudinal studies.

High-resolution imaging of the actin cytoskeleton and epithelial sodium channel, CFTR, and aquaporin-9 localization in the vas deferens.

Vas deferens is a conduit for sperm and fluid from the epididymis to the urethra. The duct is surrounded by a thick smooth muscle layer. To map the actin cytoskeleton of the duct and its epithelium, we reacted sections of the proximal and distal regions with fluorescent phalloidin. Confocal microscopic imaging showed that the cylinder-shaped epithelium of the proximal region has a thick apical border of actin filaments that form microvilli. The epithelium of the distal region is covered with tall stereocilia (13-18 µm) that extend from the apical border into the lumen. In both regions, the lateral and basal cell borders showed a thin lining of actin cytoskeleton. The vas deferens epithelium contains various channels to regulate the fluid composition in the lumen. We mapped the localization of the epithelial sodium channel (ENaC), aquaporin-9 (AQP9), and cystic fibrosis transmembrane conductance regulator (CFTR) in the rat and mouse vas deferens. ENaC and AQP9 immunofluorescence were localized on the luminal surface and stereocilia and also in the basal and smooth muscle layers. CFTR immunofluorescence appeared only on the luminal surface and in smooth muscle layers. The localization of all three channels on the apical surface of the columnar epithelial cells provides clear evidence that these channels are involved concurrently in the regulation of fluid and electrolyte balance in the lumen of the vas deferens. ENaC allows the flow of Na+ ions from the lumen into the cytoplasm, and the osmotic gradient generated provides the driving force for the passive flow of water through AQP channels.

Imaging of Prostate Cancer Recurrence in the Vas Deferens With 68Ga-PSMA PET/CT.

Two cases with Ga-PSMA-avid prostate cancer recurrence in the vas deferens are presented. These cases highlight the clinical importance of imaging the pattern of local prostate cancer recurrence and the potential difficulties that arise due to the altered anatomy in the prostate bed after prostatectomy or radiotherapy.

Vasitis: a clinical confusion diagnosis with inguinal hernia

Abstract Vasitis or inflammation of the vas deferens is a rarely described condition categorized as either generally asymptomatic vasitis nodosa or the acutely painful infectious vasitis. Vasitis nodosa, the commonly described inflammation of the vas deferens, is benign and usually associated with a history of vasectomy. Clinically, patients present with a nodular mass and are often asymptomatic and require no specific treatment.

Vasitis: a rare diagnosis mimicking inguinal hernia: a case report.

BACKGROUND: Vasitis or inflammation of the vas deferens is a rare condition, and few case reports with computed tomography images have been published since 1980. CASE PRESENTATION: A 50-year-old man presented with severe right inguinal and lower abdominal pain. Initial diagnosis at the emergency department was incarcerated or strangulated inguinal hernia. The computed tomography scan revealed diffuse edematous changes of right spermatic cord and vas deferens with peripheral fat stranding. Correlating with his clinical symptoms, signs, and imaging findings, the diagnosis of vasitis was made. We report a case of acute vasitis about the cause, symptom, pathogen, differential diagnoses, image findings, and treatment. CONCLUSION: Although very rare, vasitis should be listed as one of the differential diagnosis for inguinal mass lesions. Cross-sectional imaging may be necessary to confirm the diagnosis and exclude differentials such as an inguinal hernia. Recognition of the characteristic image findings can help to make the correct diagnosis and avoid unnecessary surgery.

Vasitis: a clinical confusion diagnosis with inguinal hernia.

Vasitis or inflammation of the vas deferens is a rarely described condition categorized as ei-ther generally asymptomatic vasitis nodosa or the acutely painful infectious vasitis. Vasitis nodosa, the commonly described inflammation of the vas deferens, is benign and usually associated with a history of vasectomy. Clinically, patients present with a nodular mass and are often asymptomatic and require no specific treatment.

Vas deferens sonographic appearances of tuberculosis lesions of 19 cases of male genital systemic tuberculosis.

To investigate the sonographic findings of the vas deferens in male genital tuberculosis.The ultrasonographic findings of the vas deferens of 19 cases of genital tuberculosis were retrospectively analyzed.According to the pathological and ultrasound findings, the ultrasonographic appearances of the vas deferens tuberculosis could be divided into 4 groups, 1 of normal sonograms, 3 of abnormal sonograms. The abnormal ultrasonographic appearances of the vas deferens tuberculosis were considered 3 categories as follows: diffusely thickening of vas deferens, nodular thickening of vas deferens, and space-occupying lesions adjacent to the vas deferens.The ultrasound manifestations of vas deferens in tuberculosis of the male genital system have certain characteristics. Combination of clinical manifestations, history of tuberculosis, experimental antituberculosis treatment, and ultrasound examination of vas deferens can suggest tuberculosis of vas deferens. Furthermore, it can provide objective basis for the comprehensive and noninvasive evaluation of the impact of genital tuberculosis on the reproductive ability for further treatments.

Chronic Vasitis After Mesh Herniorrhaphy: A Potential Cause of False Positive Results in 18F-FDG PET/CT Studies.

We report two cases of supra-scrotal vasitis incidentally detected in patients who had undergone mesh herniorrhaphy. PET/CT in patients undergoing lymphoma work-up and health check-up revealed hypermetabolic dilatation of vas deferens in the external iliac area. There were no symptoms, and blood test results did not indicate acute inflammation. Interestingly, both had undergone herniorrhaphy for inguinal hernia. Herniorrhaphy is reported to cause vasal complications such as obstruction or inflammation, although most are asymptomatic and probably under-reported. Chronic vasitis after herniorrhaphy may be a potential cause for false positive findings on F-FDG PET/CT in patients undergoing work-up for various oncological indications.

Clinical Consultation Guide on Imaging in Male Infertility and Sexual dysfunction.

Imaging can benefit clinicians in evaluating men with infertility or sexual dysfunction by giving an overview of a patient's overall clinical condition before undertaking an invasive procedure. An understanding of the limitations and advantages of image modalities used in clinical practice will ensure that clinicians can optimize patient care with imaging when necessary. PATIENT SUMMARY: The objective of this article was to review the current literature on imaging modalities used for the diagnosis and management of male infertility and sexual dysfunction. An understanding of the advantages and limitations of these imaging modalities will ensure that clinicians can optimize patient care with imaging when necessary.

[Clinical application of the disposable vasographic interventional therapy kit in vasoseminal vesiculography].

OBJECTIVE: To investigate the success rate and safety of percutaneous vasoseminal vesiculography with the disposable vasographic interventional therapy kit (VITK). METHODS: This study included ninety-six 19－65 (mean 43) years old male patients with infertility, hematospermia, seminal vesicle cyst, ejaculatory duct cyst, ejaculatory dysfunction, or vas deferens injury, with disease courses varying from 1 month to 7 years. With an open, multi-centered, single-group, self-controlled design and using the disposable VITK, we treated the patients by percutaneous vasoseminal vesiculography via injection of contrast medium into the vas deferens cavity under local anesthesia. RESULTS: Percutaneous vasoseminal vesiculography was successfully performed in 92 (97.87%) of the patients, which revealed abnormal seminal ducts in 51 cases (54.3%). Among the 28 infertile patients, 3 were found with bilateral and 5 with unilateral vas deferens obstruction. Vesiculitis was detected in 36 (81.8%) of the 44 hematospermia patients and bilateral vas deferens abnormality in 5 (38.5%) of the 13 patients with ejaculatory dysfunction. Transectional damage was observed in 2 patients with vas deferens injury induced by bilateral inguinal hernia repair. Three cases of seminal vesicle cyst and 4 cases of ejaculatory cyst were definitely diagnosed by vasoseminal vesiculography. CONCLUSIONS: The disposable vasographic interventional therapy kit, with the advantages of simple operation and high safety, deserves a wide clinical application in vasoseminal vesiculography.