Epididymal Anomalies Associated with Patent Processus Vaginalis in Hydrocele and Cryptorchidism

Abstract

The epididymal anomalies and patent processus vaginalis are frequently seen in patients with cryptorchidism or hydrocele. We performed a prospective study on the relationship between the epididymal anomalies and the patency of the processus vaginalis in boys with hydrocele (190 cases) or cryptorchidism (89 cases) who were treated from August 1997 to February 2000 (mean age, 51 months; range, 12 to 152 months). The epididymal anomalies were observed with an overall frequency of 48%. Closed, partially closed, and open processus vaginalis were associated with an epididymal anomaly in 14, 38, and 65% of cases, respectively. The epididymal anomalies were more common in association with undescended (61%) than with descended (43%) testes without statistical significance (p=0.415). Incomplete attachment of the caput epididymis was the most common anomaly (35%), followed by detachment of caput and cauda epididymis (31%), cauda epididymis (24%), and long looping epididymis (10%). These data showed that the epididymal anomalies were strongly associated with the patency of the processus vaginalis irrespective of testicular descent (p<0.001), and they provide further evidence for the hypothesis that a common stimulus, possibly androgens, may be required for the epididymal development and obliteration of the processus vaginalis.

Advantages of Video-Assisted Approach in Detecting Epididymal Anomalies and Treatment of Nonpalpable Testis

“…If we exclude the same most common configuration in our series, the other configurations we found were 6/13 of cases (46%). The epididymal anomalies occur in association with undescended testes in 32-79% of the cases [11,12]. It is accepted that a range of epididymal anomalies exists in boys with undescended testis, varying from ductal patency aberrations to abnormal attachments of the epididymis to the testes or even complete absence [5,13].…”

The Epididymis: Embryology, Structure, Function And Its Role In Fertilization And Infertility

“…Testicular maldescent, then, is commonly associated with epididymal anomalies. However, most epididymal abnormalities are not likely to have contributed to testicular maldescent (Elder, 1992;Han & Kang, 2002). Cryptorchidism is a disease in which the testes and the epididymis are retained in the inguinal tract and the seminiferous tubules become atrophic as a result of the increase in temperature, which does not favor spermatogenesis (Garcia et al, 2011).…”

340 Relationship between Undescended Testis Position and Prevalence of Testicular Appendices, Epididymal Anomalies and Patency of Processus Vaginalis

“…Knowledge of anomalies associated with cryptorchidism is relevant in clinical practice, both to prevent accidents during orchidopexy and to predict infertility in the future (and counsel patients/parents), such as in cases of epididymis atresia and total disjunction between the testis and the epididymis [19,20]. EAs are frequently found in cryptorchidism [5,13,14].…”

“…EAs are frequently found in cryptorchidism [5,13,14]. The abdominal testicles present a higher index of these anomalies [3,19]. Previous studies on fetuses and children without cryptorchidism have demonstrated an incidence of EAs below 4% [15,16].…”