Ejaculatory duct obstruction caused by a right giant seminal vesicle with an ipsilateral upper urinary tract agenesia: an embryologic malformation.

OBJECTIVE: To report our experience with TURED in infertile men with EDO associated with abnormal development of the mesonephric or Wolffian duct, causing a contemporary malformation of the ipsilateral upper urinary tract. DESIGN: Retrospective clinical study. SETTING: Infertile men in an hospital environment. PATIENT(S): Seven patients affected by Zinner syndrome, from March to September 2005, were selected. INTERVENTION(S): Underwent TURED. MAIN OUTCOME MEASURE(S): Semen analysis, endocrine profile, transrectal ultrasonography and seminal vesicles aspiration, excretory urography, computerized tomography (CT), or magnetic resonance imaging (MRI). RESULT(S): Before surgery, the patients experienced a decreased intensity and force of ejaculation and a low motile sperm count. The detection of the ipsilateral upper urinary tract malformation by the patients was incidental. After surgery, all patients reported having a projectile ejaculation, an increase in the average postoperative volume, and of the total motile sperm count. CONCLUSION(S): A seminal vesicle cyst combined with ipsilateral renal agenesis, described as Zinner syndrome, is a rare urological anomaly. It is frequently asymptomatic or else characterized by infertility, symptoms of bladder irritation, or pain in the scrotum and perineum. In selected patients, TURED can improve semen quality with subsequent ability to impregnate. The upper urinary tract malformation should be treated in symptomatic cases only.

Reduced endogenous estrogen delays epididymal development but has no effect on efferent duct morphology in boars.

The study presented herein was designed to test the hypothesis that reduced endogenous estrogen in the boar alters efferent duct morphology, epididymal morphology, and steroid receptor expression. Twenty-eight littermate pairs of boars were treated with Letrozole, an aromatase inhibitor, or with vehicle from 1 week of age until castration at 2 through 8 months. Efferent ducts and epididymides were examined for morphological development and steroid receptor expression. Efferent duct morphology was not different between control and Letrozole-treated animals at any examined age. Androgen receptor (AR), estrogen receptor alpha (ERalpha), and beta (ERbeta) were expressed in the epithelial cells of the efferent ducts at all ages; expression was similar in control and treated animals. Morphological development of the caput and corpus was delayed in Letrozole-treated animals, but this delay was transient since morphology was similar between control and treated animals at 8 months. The cauda did not show a delay in development, but was more developed in treated animals at 2 months. AR, ERalpha, and ERbeta were expressed in all three epididymal regions; no difference was observed between control and treated animals. In summary, estrogen appears to be important for development of the epididymis; however, the cauda may be regulated differently than the caput and corpus. Results for the efferent ducts suggest that the normally high endogenous estrogens are not required for regulation of fluid reabsorption in the boar. It also suggests that any ER activation required for maintenance of efferent duct morphology and function is normal in Letrozole-treated boars.

Expression of estrogen receptors in the efferent ductule of male sheep fetuses during gestation.

There is as yet no report about the developmental changes of estrogen receptors (ERs) in the male reproductive system of the sheep fetus. In the present study, the testis, efferent ductule, and epididymis of sheep fetuses were collected at days 70, 90, and 120 of gestation and in the newborn lamb. ER alpha (ERalpha) and ER beta (ERbeta) were detected by immunohistochemistry. The results showed that ERbeta staining was negative in all of the examined tissues throughout gestation, whereas ERalpha immunoreactivity was only located in the nuclei of the efferent ductule epithelium. In addition, both ERalpha staining intensity and the number of ERalpha-positive cells were higher at day 90 of gestation, compared with that at day 70 and at birth. These results suggest that estrogen may play important roles in efferent ductule development in sheep fetuses.

[Malformations of Wolffian duct derived male genital organs (epididymis, vas deferens, seminal vesicules, ejaculatory ducts)]. / Malformations des organes génitaux masculins issus du canal de Wolff (épididyme, déférent, vésicule séminale, canal éjaculateur).

OBJECTIVES: To analyse embryological phenomena, in order to define a practical approach to management. METHODS: The authors reviewed the files of eight boys with an abnormality of Wolffian duct derived genital organs, consisting of three cases of vas deferens agenesis, two of which were accompanied by homolateral renal agenesis, one case of ectopic vas deferens with contralateral renal agenesis, three cases of duplicated vas deferens and one congenital seminal vesicle cyst with renal agenesis. DISCUSSION: Congenital malformations of the epididymis consist of cysts and agenesis or partial atresia. Cysts essentially raise a problem of differential diagnosis. Treatment is only required in the case of severe discomfort. Vas deferens agenesis is the commonest lesion, an incidental finding in children. An experimental treatment is proposed in adults. Duplications, interdeferential communications and deferentomegaly are much rarer lesions. Seminal vesicle cysts are well visualized by transrectal ultrasonography and should be treated surgically. Lastly, ejaculatory ducts may present urethroseminal reflux or may be ectopic. CONCLUSION: The possibility of absent or ectopic vas deferens should be considered in the case of unilateral renal agenesis. Vas deferens agenesis justifies examination of the contralateral side and investigation to exclude renal agenesis. Congenital cysts of the epididymis only require surgery when they are symptomatic. The presence of ipsilateral renal agenesis should be investigated in the case of cystic dilatation of the seminal vesicle.