Partial obstruction of the seminal path, a frequent cause of oligozoospermia in men

Abstract

The objective of this clinical study was to determine the real frequency and clinical importance of partial obstruction of the seminal path in patients with oligozoospermia. We have designed a prospective clinical study including men with oligozoospermia seen at an andrological consultation in both private and institutional hospitals. A testicular biopsy was done on all patients under local anaesthesia. A complete study for sterility was also done [hormonal determinations: follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, testicular ultrasound, semen analysis, testicular Doppler ultrasound, etc.]. We have made a quantitative and qualitative evaluation of testicular biopsy (percentage of tubules with Sertoli cell only or with hyalinization; mean tubular diameter; number of spermatogonia, primary spermatocytes, young spermatids, mature spermatids and Sertoli cells; and evaluation of testicular interstitium: number of Leydig cell clusters, presence of angiectasis, presence of perivascular inflammation). Sixty one per cent of all oligozoospermia cases were obstructive. The principal cause of obstructive oligozoospermia was the presence of testicular varicocele. In obstructive oligozoospermia, the tubular diameter and number of mature spermatids are statistically significantly higher than in non-obstructive oligozoospermia. Obstructive oligozoospermia is a frequent condition caused by partial obstruction of seminal path. A quantitative analysis of the testicular biopsy is the only method of diagnosis.

Testicular adrenal rest tumors in patients with congenital adrenal hyperplasia can cause severe testicular damage

“…In these cases, adverse effects of the obstruction on the germinal epithelium or Leydig cells were not reported (25,27). This can be explained by the ability of the epididymis to become enlarged, to accommodate the sperm cells and to phagocytize and resorb spermatozoa (25).…”

Testicular Adrenal Rest Tumours in Congenital Adrenal Hyperplasia

“…Furthermore, we found a severe decrease in the number of germ cells in all patients. In the literature, obstructive azoospermia is described mainly as a result of extratesticular obstruction due to infections or surgical interventions mostly located at the epididymis or vas deferens [31–34]. In these cases, adverse effects of the obstruction on the germinal epithelium or Leydig cells were not reported [32, 34].…”

“…In the literature, obstructive azoospermia is described mainly as a result of extratesticular obstruction due to infections or surgical interventions mostly located at the epididymis or vas deferens [31–34]. In these cases, adverse effects of the obstruction on the germinal epithelium or Leydig cells were not reported [32, 34]. This can be explained by the ability of the epididymis to become enlarged to accommodate the sperm cells and to phagocytise and resorb spermatozoa [32].…”

The state of the Sertoli cells in the children and adolescents presenting with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

“…Так как ТАРТ имеют парацентральное распо-ложение, они уже на ранних стадиях развития мо-гут привести к нарушению сперматогенеза за счет обструкции на уровне придатка яичка [25]. Прида-ток яичка выполняет функцию резервуара для спермы и может компенсаторно расширяться; кроме того, внутри придатка возможен фагоцитоз и резорбция поврежденных сперматозоидов [26].…”