van Wingerden J J, Franz I
J Urol. 1984 Apr;131(4):764-6. doi: 10.1016/s0022-5347(17)50614-x.
Experience with 2 patients stimulated a review of the literature on congenital absence of the vas deferens in 133 cases. Bilateral absence was more common and occurred in 80 per cent of the cases, and a caput epididymidis was said to be present in at least 88 per cent. Information concerning the epididymis was lacking in 8.9 per cent of the cases. Two probable explanations for this common clinical finding are offered. Embryologic studies have shown that the caput, unlike the rest of the epididymis, can develop from genital ridge derivatives mainly. This clinical-embryological consideration refutes the common belief that the vas deferens and epididymis as a whole are of mesonephric duct origin. A second, independent factor is the selective blood supply of the caput in some cases. In these cases the caput is preserved by a branch of the testicular artery, perforating the tunica albuginea from within outwards, instead of a branch of the spermatic artery originating from the extratesticular portion of the testicular artery.
对2例患者的诊治经历促使我们对133例先天性输精管缺如的文献进行了回顾。双侧缺如更为常见，占病例的80%，据说至少88%的病例存在附睾头。8.9%的病例缺乏有关附睾的信息。针对这一常见临床发现提出了两种可能的解释。胚胎学研究表明，与附睾其余部分不同，附睾头主要可由生殖嵴衍生物发育而来。这种临床 - 胚胎学考量反驳了输精管和附睾整体均起源于中肾管的普遍观点。第二个独立因素是某些情况下附睾头的选择性血液供应。在这些病例中，附睾头由睾丸动脉的一个分支供血，该分支从睾丸白膜内部向外穿入，而不是起源于睾丸动脉睾丸外部分的精索动脉分支。
