Patient's question:
I have been married to my husband for 2 years, but we haven't been able to conceive. Recently, the hospital said that my husband has a blocked vas deferens. I would like to ask if there is a way to treat this? Is surgery the only option to restore it? If surgery is performed, how long does it usually take to recover after the procedure?Doctor's answer:
Sperm ejection must pass through the efferent ductules of the testis, the epididymal duct, the vas deferens, the ejaculatory duct, and part of the urethra. Obstruction in any of these areas can affect sperm ejection. If the obstruction is unilateral in the vas deferens, it has little impact on fertility; if bilateral obstruction occurs, where sperm cannot be expelled normally, it will lead to infertility. The common factors or causes leading to vas deferens obstruction are as follows:1. Urogenital infections, such as epididymitis, prostatitis, seminal vesiculitis, or epididymal-vas deferens tuberculosis, can cause obstruction of the vas deferens, with the connection between the epididymis and the vas deferens being the most common site.
2. Injuries, such as inguinal hernia repair, varicocele surgery, or testicular tumor surgery, may damage the vas deferens.
3. Surgical procedures for epididymal spermatocele or hydrocele may injure the epididymis.
4. Prostate surgery can cause obstruction of the ejaculatory duct. Even without direct injury, postoperative infections, adhesions, or scar formation may compress or obstruct the duct system.
5. Tumors, such as testicular tumors, seminal vesicle tumors, or prostate tumors, can block the duct system.
6. Congenital anomalies, such as the absence of the head, body, or tail of the epididymis, partial or complete absence of the vas deferens, non-connection between the vas deferens and epididymis, or underdevelopment of the epididymis, vas deferens, or seminal vesicles.
Obstruction of the duct system can result in obstructive azoospermia, also known as pseudo-azoospermia in clinical practice. Its clinical manifestations and characteristics include: normal-sized testes, absence of sperm, normal levels of follicle-stimulating hormone (FSH) and testosterone, and normal histopathological findings in testicular biopsy. However, definitive diagnosis requires contrast imaging. If diagnosed, surgical intervention is typically required to resolve the obstruction.