D'Agostino S, Campobasso P, Spata F, Belloli G
Divisione di Chirurgia Pediatrica, Ospedale Regionale di Vicenza, Italia.
Pediatr Med Chir. 1994 Nov-Dec;16(6):509-12.
A range of epididymal and vasal anomalies (EVA), varying from ductal patency aberrations to abnormal attachments of the epididymis to the testis or even complete absence, exists in boys with cryptorchidism, but there are few studies of normal controls for comparison. In the present study anatomy of testicular-epididymal relationships were recorded in 517 cryptorchid patients (423 unilateral and 94 bilateral) and in 192 boys who underwent inguinal exploration for inguinal hernia or hydrocele. The postmortem anatomic relationship of the testis and epididymis in 50 adults was also examined. The operative findings were divided into two groups: simple variants of normal and forms of complete anatomic disconnection of the spermatic ducts (EVA). We were unable to find EVA in the control groups. In contrast EVA was present in the 20% of cryptorchid patients. The incidence was 16.5% in unilateral cryptorchidism and 26% in bilateral cases, in 17% of whom the EVA was bilateral. According to the literature and our previous study azoospermia is present in about 18-20% of adults operated upon in childhood for bilateral cryptorchidism. Our present study may suggest that azoospermia in adults operated on for bilateral cryptorchidism could be partially related to some forms of bilateral occlusion or interruption of the spermatic ducts.
患有隐睾症的男孩存在一系列附睾和输精管异常（EVA），从导管通畅异常到附睾与睾丸的异常附着甚至完全缺失，但很少有针对正常对照进行比较的研究。在本研究中，记录了517例隐睾症患者（423例单侧和94例双侧）以及192例因腹股沟疝或鞘膜积液接受腹股沟探查的男孩的睾丸-附睾关系解剖结构。还检查了50例成年人睾丸和附睾的尸检解剖关系。手术结果分为两组：正常的简单变异型和精索导管完全解剖分离的形式（EVA）。我们在对照组中未发现EVA。相比之下，20%的隐睾症患者存在EVA。单侧隐睾症的发生率为16.5%，双侧病例为26%，其中17%的EVA为双侧性。根据文献和我们之前的研究，童年期接受双侧隐睾症手术的成年人中约18 - 20%存在无精子症。我们目前的研究可能表明，童年期接受双侧隐睾症手术的成年人出现无精子症可能部分与某些形式的双侧精索导管阻塞或中断有关。
