Patient's question:
Male, 33 years old, with symptoms of vas deferens obstruction.Doctor's answer:
For your situation, it is recommended to go to the hospital for a detailed examination. The following information about how to check for vas deferens blockage is for reference only:1. Semen Analysis
- No sperm or a low sperm count in the semen.
(1) For bilateral obstruction above the ejaculatory duct (excluding the prostatic part), the semen appears with low volume, no sperm, low fructose content, and an acidic pH, with high citric acid content.
(2) Obstruction of the vas deferens above the prostatic part (including the prostatic part) shows reduced semen volume, no sperm, a neutral or alkaline pH, and low fructose and citric acid content.
(3) If there is a small amount of sperm in the semen, it suggests partial or incomplete obstruction of the vas deferens.
2. Vasography
- Under local anesthesia, a small incision is made in the scrotum to fix and display the vas deferens. A 21-gauge needle is used first to inject about 0.5 mL of 60% diatrizoate meglumine in the direction of the epididymis, which can reveal the distal vas deferens and epididymis. Subsequently, the needle can be punctured toward the seminal vesicle, injecting 2–3 mL of diatrizoate meglumine, which can display the proximal vas deferens, seminal vesicle, and ejaculatory duct. Recently, some scholars have reported performing percutaneous vasography without a scrotal incision.
- A normal vasography should show the normal morphology and position of the vas deferens, seminal vesicle, and ejaculatory duct, all filled with contrast medium.
3. Surgical Exploration
- Surgical exploration of the scrotum is another important method for diagnosing vas deferens obstruction, as some conditions cannot be detected through physical examination or vasography. The order of exploration is the testis, epididymis, and vas deferens. Testicular biopsy can be performed during exploration. The best approach is to combine exploration and surgical treatment to avoid a second surgery.