[Cryptorchidism: anomalies of excretory ducts and azoospermia]

A range of epididymal and vasal anomalies (EVA), varying from ductal patency aberrations to abnormal attachments of the epididymis to the testis or even complete absence, exists in boys with cryptorchidism, but there are few studies of normal controls for comparison. In the present study anatomy of testicular-epididymal relationships were recorded in 517 cryptorchid patients (423 unilateral and 94 bilateral) and in 192 boys who underwent inguinal exploration for inguinal hernia or hydrocele. The postmortem anatomic relationship of the testis and epididymis in 50 adults was also examined. The operative findings were divided into two groups: simple variants of normal and forms of complete anatomic disconnection of the spermatic ducts (EVA). We were unable to find EVA in the control groups. In contrast EVA was present in the 20% of cryptorchid patients. The incidence was 16.5% in unilateral cryptorchidism and 26% in bilateral cases, in 17% of whom the EVA was bilateral. According to the literature and our previous study azoospermia is present in about 18-20% of adults operated upon in childhood for bilateral cryptorchidism. Our present study may suggest that azoospermia in adults operated on for bilateral cryptorchidism could be partially related to some forms of bilateral occlusion or interruption of the spermatic ducts.