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Query: UNIPROT:P56851 (epididymal)
 11,273 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic unspecific genital infections cause unexplained male fertility disorders. The andrologist in clinical practice is referred to the significance of macrophages in the seminal fluid and to an abnormal staining of the spermatozoal flagella during the Papanicolaou' and Shorr' techniques. These two criteria may be helpful in diagnosing chronic unspecific genital infection and in differentiating chronic epididymal inflammation from chronic prostatitis, whereas the influence of bacteria is still controversial.
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PMID:Macrophages in semen are indicative of chronic epididymal infection. 238 92

Results of a 1981 study are complemented and analyzed with respect to epididymal histology in 94 patients undergoing uni- or bilateral epididymo-deferential anastomosis. Testicular histology was normal in all patients. Epididymal histology could be differentiated into two main groups: one with normal or only slightly altered epididymis, the other with major epididymal lesions. Repermeabilization was more frequent and of better quality (10 X 10(6) sperm/ml or more) in the first group, in which there were also all the pregnancies. Previous genital infection or injury is of poor prognosis due to the severe epididymal lesions present.
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PMID:[Epididymal prognostic factor in epididymo-deferential anastomosis]. 376 Jun 4

In a randomized, placebo-controlled, double-blind study we investigated whether high-dose oral treatment with vitamins C and E for 56 days was able to improve semen parameters of infertile men. Ejaculate parameters included semen volume, sperm concentration and motility, and sperm count and viability. Thirty-one patients without genital infection but with asthenozoospermia (< 50% motile spermatozoa) and normal or only moderately reduced sperm concentration (> 7 x 10(6) spermatozoa/ml) (according to WHO criteria) were examined. To investigate the influence of the epididymal storage period on semen parameters, the patients were asked to deliver two semen samples with abstinence times of 2 and 7 days both before and at the end of vitamin treatment. After randomization, the patients received either 1000 mg vitamin C and 800 mg vitamin E (n = 15) or identical placebo capsules (n = 16). No changes in semen parameters were observed during treatment, and no pregnancies were initiated during the treatment period. Combined high-dose antioxidative treatment with vitamins C and E did not improve conventional semen parameters or the 24-h sperm survival rate. Prolonged abstinence time increased ejaculate volume (P < 0.05), sperm count (P < 0.05), sperm concentration (P < 0.05) and the total number of motile spermatozoa (P < 0.05).
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PMID:Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebo-controlled, double-blind study. 1060 Nov 11

The authors carried out a retrospective study of 162 cases of male infertility explored in a hospital unit in Lyon, France. Assays of 1 -alpha-1,4-glucosidase (epididymal function marker) backed up by clinical findings were used to select 3 types of epididymal malfunction. 1) There was complete obliteration of the epididymal duct, resulting in azoospermia. This diagnosis was based on both testicular biopsy findings, demonstrating unimpaired spermatogenesis and on the dramatically reduced level of assayed activity ( 40 mIU/ejaculation), as well as on clinical findings. 2) There was anamalous epididymal function combined with moderate oligoasthenozoospermia or normospermia. In these cases, low levels of assayed activity do not parallel fairly high sperm counts (between 20-30 million spermatozoal/ml). 3) There were those cases which were difficult to interpret and which involved severe oligoasthenozoospermia ( 5 million/ml) and reduced level of epididymal marker, suggesting partial blockage of the epididymis due to a focus of infection. Varicoceles were found more frequently among the European population, whereas a history of genital infection was more frequent among the North African population. However, when the various types of abnormality in the spermatogram were related to patient history and epididymal abnormality, no differences were found between the 2 populations. (author's modified)
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PMID:[Comparative study of epididymal disorders in two populations of male patients consulting for infertility: one from the Maghreb region of North Africa and the other of European origin]. 1231 60

A history of urogenital inflammation occurs in 5-12% of men attending infertility clinics. Usually, infection has a detrimental effect on sperm quality by reducing concentration and motility, and possibly affecting the number of morphological normal spermatozoa. In addition, infection may be the source of auto-antibodies against spermatozoa, found in about 8% of the infertile male population. In contrast to the situation in women, there is no clear evidence that male accessory gland infections can result in epididymal blockage or vassal obstruction, with the exception of genital tuberculosis. Although Chlamydia trachomatis is a well-documented source of chronic prostatitis, the infection does not seem to cause obstruction of the reproductive tract, as it does in women. If male urogenital infection causes obstruction it is most likely located at the level of the ejaculatory ducts. Chronic prostatitis has been proved to cause scarring of the prostatic and ejaculatory ducts, resulting in low seminal volume with low fructose and alpha-glucosidase. Many of these men present with severe oligozoospermia or azoospermia, normal size testis and normal gonadotrophins. We performed an excisional testicular biopsy in all men presenting with <1 million spermatozoa per millilitre and found that 39 of 78 (50%) had a normal spermatogenesis. A history of male accessory genital infection was found in 12% of the men and 10% had abnormalities found on transrectal ultrasound of the prostate (like oedema, dilatation of the seminal vesicles and ejaculatory ducts) intraprostatic calcifications and dilatation of the periprostatic venous plexus. Ejaculatory duct obstruction is a common cause of male infertility and infections are present in at least 22-50% of these men. Transurethral resection of the ejaculatory ducts may result in a significant improvement of the sperm quality and in spontaneous pregnancies in up to 25% of the couples. In case of failure sperm aspiration from the epididymis and intracytoplasmic sperm injection is the treatment of choice.
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PMID:Inflammatory-associated obstructions of the male reproductive tract. 1453 64

Microsurgical longitudinal intussusception vasoepididymostomy (LIVE) has been widely used to treat epididymal obstructive azoospermia since 2004. Although the deferential vasculature plays an important role in supplying blood to the testis and epididymis, little attention has been paid to the potential benefits of sparing the deferential vessels during the anastomosis in LIVE. This study aimed to evaluate the efficacy and safety of deferential vessel-sparing LIVE in humans. From December 2013 to December 2015, 69 azoospermic men with epididymal obstruction due to a genital infection, trauma, or idiopathic factors underwent deferential vessel-sparing LIVE in the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. The outcomes of these patients were analyzed retrospectively. The mean age was 31.1 years for men and 28.3 years for their partners. Fifty-nine (85.5%, 59/69) men were followed up after surgery for approximately 16 months. Patency was noted and confirmed by semen analysis (>10 000 sperm/ml) in 83.1% (49/59) of men. The natural pregnancy rate was 40.7% (24/59) by the end of the study, with 87.5% (21/24) of these natural pregnancies achieved within 12 months after surgery. No severe adverse events or complications were observed. In this study, we present a novel technique for sparing the deferential vessels during LIVE. The preliminary outcomes show this technique to be safe with favorable patency and pregnancy rates.
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PMID:A novel experience of deferential vessel-sparing microsurgical vasoepididymostomy. 2997 84