A spectrum of epididymis and vas deferens anomalies among children with cryptorchidism: a retrospective multi-center study

Ahmed Badawe G. Hassan,Mohamed A. Baky Fahmy,Mohammed Hamada Takrouney,Sarah Magdy Abdelmohsen,Mohamed El Debeiky,Mohamed Abdelkader Osman,Mohamed Mahmoud Abd El-Aleem Shalaby

doi:10.1186/s43159-021-00111-w

Abstract

BackgroundVasoepididymal anomalies are not rare among children with cryptorchidism. They may affect fertility following orchiopexy. Herein, we describe the cases of abnormalities of the vas deferens and epididymis in children undergoing orchidopexy for cryptorchidism. Data were collected retrospectively from six centers providing care for patients with undescended testicles from September 2017 to February 2019. All patients whose congenital anomalies of the epididymis or vas deferens were discovered incidentally during operative intervention for cryptorchidism and where photographs of the anomalies were taken were included.ResultsThe total incidence of congenital anomalies on the 467 testicles which had operations was 13.2%. Congenital epididymal and vas deferens anomalies were more common on the left side than the right side in patients with cryptorchidism (P = 0.038). Attachment anomalies between the epididymis and testis were the most common epididymal anomaly (36.3%), while a vanished vas deferens was the most frequent vas deferens anomaly (18%). Three patients had absent vas deferens, two had curled vas deferens, two had vas deferens separated from the epididymis, and one had a duplicated vas deferens. Three patients had an epididymal cyst, one had an enlarged appendix of the epididymis, and one had epididymal agenesis.ConclusionAttention must be paid during any surgery on an undescended testicle as an anomaly of the vas deferens could lead to unexpected complications. Anomalies of the vas deferens or epididymis that present in cases of cryptorchidism occur mostly on the left side.

Highlights

Vasoepididymal anomalies are not rare among children with cryptorchidism
An undescended testicle, a common congenital anomaly affecting approximately 2% of male neonates, can be associated with a wide range of other congenital anomalies. These children, whether or not they undergo surgery, may have sequelae of poorly functioning testicles attributed to a wide spectrum of other congenital anomalies that can affect the testicle, epididymis, or vas deferens. These anomalies may be associated with infertility which may be improved in some cases with an early orchiopexy
While anomalies of the testis, epididymis, and vas deferens are found in 2% of normal male fetuses, epididymal anomalies are more common in cryptorchid testes [1]

Summary

Introduction

Vasoepididymal anomalies are not rare among children with cryptorchidism. They may affect fertility following orchiopexy. A common congenital anomaly affecting approximately 2% of male neonates, can be associated with a wide range of other congenital anomalies These children, whether or not they undergo surgery, may have sequelae of poorly functioning testicles attributed to a wide spectrum of other congenital anomalies that can affect the testicle, epididymis, or vas deferens. These anomalies may be associated with infertility which may be improved in some cases with an early orchiopexy. Most descriptions of these anomalies are isolated case reports or are from selected populations and are of limited statistical value [2]

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