Epididymectomy, Seminal Vesiculectomy and Hydrocelectomy for Epididymitis, Seminal Vesiculitis and Hydrocele

Calcium Homeostasis in the Epididymal Microenvironment: Is Extracellular Calcium a Cofactor for Matrix Gla Protein-Dependent Scavenging Regulated by Vitamins

“…While male fertility research is predominantly focused on spermatogenesis and the biology of spermatozoa following their release from the epididymis, accumulating evidence points to epididymal function being critical for sperm activity and male fertility ( Silvert and Stanisic, 1980 ; Chen et al, 2016b ; Sharma et al, 2016 ; Sharma et al, 2018 ; Tuttelmann et al, 2018 ; Conine et al, 2019 ; Sharma, 2019 ; Kiyozumi et al, 2020 ). One unique feature of the epididymal luminal environment is its acidity and low calcium (Ca 2+ ) concentration ( Levine and Marsh, 1971 ; Levine and Kelly, 1978 ; Au and Wong, 1980 ; Jenkins et al, 1980 ; Hong et al, 1984 ; Breton et al, 1996 ; Clulow and Jones, 2004 ; Da Silva et al, 2007 ; Weissgerber et al, 2011 ).…”

“…Although male infertility is common, affecting approximately 15% of couples of child-bearing age worldwide ( Zegers-Hochschild et al, 2009 ; Joffe, 2010 ; Esteves, 2013 ; Winters and Walsh, 2014 ; Tuttelmann et al, 2018 ; Agarwal et al, 2021 ), more than 50% of cases are idiopathic, i.e., of unknown cause, which limits our ability for developing targeted therapies. In some clinics before the intervention of antibiotics, epididymal deficits are estimated to be involved in 50–80% of male infertile patients ( Silvert and Stanisic, 1980 ). Hence, an improved understanding of epididymal function permitting sperm maturation holds the promise of improved diagnosis and treatment of male infertility.…”