先天性精管欠如症について

Abstract

Clinical pictures were described on 19 cases of congenital a plasia of the vas deferens. Of 19, 17 cases showed male sterility with azoospermia and the other cases had hemospermia etc. The 17 cases who had a chief complaint of sterility represented 1.2 % of a total of 1 , 4 30 patients with male sterility, 3.5 % of a total of 487 patients with azoospermia and 47.2 % of a total of 36 patients with obstructive azoospermia, respectively. On 5 cases who were performed exploratory op e ration for pelvic seminal tracts, the seminal vesicle and findings of the vas in pelvic portion were examined. As the results, 2 cases showed normal seminal vesicles in both sides, 2 cases showed aplasia of the seminal vesicle and the remaining case showed unilateral hypoplasia of the seminal vesicle associated with cystic dilatation of the ejaculatory duct in the counter side. The status of aplasia of the vas deferens w a s not simple. Beside total aplasia, cases of partial aplasia were discovered. For partial aplasia 2 different types were found, consisting of "external aplasia" (aplasia in only funiculoinguinal portion of the vas deferens) and "internal aplasia" (aplasia in only pelvic portion of the vas deferens). Such variety of pictuers is contradictory to the pathogenetic hypothesis that the aplasia of vas deferens is developed due to absence of the Wolffian duct from early fetal life. It will be proper to suppose that the aplasia of vas deferens is the outcome of degenerative change which took place during the process of maturation with some unknown reasons.