Santiago Brugo Olmedo M.D.
Medical Director
Seremas Medicine for men and women
Seremas Home Seremas Surgery Seremas Reconstructive microsurgery of spermatic ducts

Reconstructive microsurgery of spermatic ducts

One of the most common epididymis affections is inflammation or infection, and both cases are called Epididymitis.

The patient suffering from this disease experiences pain and shows an enlargement and “swelling” of the testicular zone.

Why does it happen?
Epididymitis can be caused by trauma in the area (for example a kick or stroke with a ball in the genitals), by bacteria, or even by the tuberculosis bacillus (Epididymitis tuberculosa).

In general, pain disappears within a couple of days, four or five at the most, but seriousness of the patient’s condition is given by the consequences.

Which are the consequences?
Epididymis is so thin that the process of treating it in general also results in fibrosis in the area, which totally obstructs the epididymal tube.

This obstruction prevents the testis spermatozoa from going through it on their way out. If this happens in both epididymis, the patient will become azoospermic. The volume of ejaculate does not change, it is neither more nor less, because as we have already said, semen is made of glands annex to the testis, which are the seminal vesicles and the prostate.

In other words, the man who has both epididymis totally obstructed, does not have spermatozoa (he is azoospermic) but ejaculates normally.

What about deferens?
Obstruction of vas deferens may be consequence of an infection or swelling, deferentitis, or the consequence of medical iatrogenia (medical error) after surgery of groin hernia (bilateral groin herniorrhaphy) mainly in young children.

Just like in the previous case, the volume of ejaculate does not change but the patient has azoospermia.

Are testis also affected?
In the case of epididymis bilateral obstruction as well as in that of deferens ducts, the size of testis is totally normal, and their function generating spermatozoa is almost totally conserved.

They keep on producing spermatozoa which are phagocyted by white cells. However, testicular production becomes slower.

What can be done in those cases?
When the epididymis or vas deferens obstruction occurs in the same place, in other words, it does not affect the whole tube, surgery is recommendable and expectation of a cure, especially in the case of deferens, is very good. Approximately 80-90% of surgeries to treat deferens obstruction are successful.

On the other hand, in case the swelling or infection took the whole epididymis or deferens duct, there would not be chances of cure with surgery.

This type of surgery must be performed with a magnifier or surgical microscope and using thread for suture which is as thin as a hair.

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