Tubular ectasia of the epididymis: a sign of postvasectomy status

To find out if "tubular ectasia of the epididymis" is suggestive of postvasectomy status.

Tubular ectasia of the epididymis is defined as enlargement of the epididymis with multiple interfaces (i.e., a speckled appearance). We found 24 cases exhibiting tubular ectasia of the epididymis over a period of six years. We reviewed the sonographic findings of tubular ectasia of the epididymis and evaluated the prevalence of associated findings.

In 24 patients with tubular ectasia of the epididymis, 16 cases were bilateral, five were right-sided, and three were left-sided. Twenty-one patients had history of vasectomy, of the three remaining cases, 1 had history of inguinal hernia repair, one had prostatitis, and one had undetermined etiology. Associated abnormalities included dilated vas deferens (n = 4), tubular ectasia of the testis (n = 2), large spermatoceles (n = 6), hydrocele (n = 3), and varicocele (n = 4). In 2 cases, spermatic granulomas were suspected.

Tubular ectasia of the epididymis is suggestive of postvasectomy epididymis. This sonographic feature is helpful in evaluating a patient with scrotal discomfort. However, this sign can also be associated with other causes of vas obstruction.