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Surgical Exploration of the Testes

By: Sangeet Khanna - Updated: 26 Jul 2012 | comments*Discuss
 
Vasoepididymostomy Vasovasostomy Vas

Testes are the principle organs of the male reproductive system. It is located within a sac called the scrotum. Testes produce and store sperm as well as produce the male hormones called testosterone. This hormone and its derivatives control the growth of the reproductive organs, as well as give males their characteristic appearance and hair distribution. In normal conditions, the male reproductive system produces, accumulates and transports sperm. In cases of fertility evaluation, you may require surgical exploration of the testes to assess the root cause of the male infertility. In most cases however, the surgical decision is further along in the fertility evaluation process.

Causes of Infertility
The causes of infertility are numerous, and include various genetic diseases, infections and even environmental factors. Of all the causes only a few warrant a surgical exploration of testis. Testicular cancer, testicular torsion and testicular trauma are some of the causes, which warrant a surgical consult. Testicular torsion is a surgical emergency whereby the testes get entangled by the cord with which they hang. This torsion causes a compromise in the blood flow and can lead to permanent damage, if not addressed immediately. Testicular torsion is excruciatingly painful and occurs suddenly without warning. The torsion can only be corrected by emergency surgery to unwind the testis. If the testes remain entangled the testis may not be salvaged. Testicular trauma is another cause for concern, which may also require surgery to repair. The main issue in testicular trauma is rupture of the testicle. If the testis ruptures there will be fluid leakage and build up within the scrotal sac causing swelling and pain. Testicular cancer can occur at any age, even in young men. The good news is that in most cases it is quite curable. If testicular cancer is suspected, diagnostic imaging will be required and in most cases a biopsy will be done as well. The biopsy is used to collect a collection of cells to be examined for cancerous growth. In cases where the diagnosis is still uncertain even after biopsy, the testis may require a surgical evaluation and tissue samples will be sent for a pathological report.

Surgical Procedures
Various surgical procedures exist to help explore areas of interest to identify and even treat the cause of male infertility. These procedures are preformed to circumvent obstruction within vital reproductive organs. The vas deferens is analogous to the fallopian tubes of the female reproductive tract; they help transport sperm from the epididymis to the seminal vesicles. In cases of obstruction in the vas deferens, a vasovasostomy will be preformed to bypass the blockage. Obstruction within the vas deferens is a common cause of infertility. In cases of vasectomy reversal, there may be obstruction in the future due to adhesions and scar tissue. If the obstruction occurs within the epididymis-vas deferens junction, a vasoepididymostomy may be required. This is a more complicated surgical procedure since it involves both the vas deferens and the epididymis. The delicate structure of the epididymis makes this procedure even more difficult. This procedure may be tried in complicated infections involving the epididymis as well.

Advances in microsurgical techniques, have lead to effective treatments in the area of male infertility. Whether it is testicular cancer or testicular torsion, testicular surgery can prove lifesaving. Male fertility treatment options range from medication, lifestyle adjustments, and microsurgical techniques. It is best to discuss with your doctor the diagnosis and all the treatment options available.

In normal conditions, the male reproductive system produce, accumulate and transport sperm. In cases of fertility evaluation, you may require surgical exploration of the testis to assess the root cause of the male infertility. In most cases however, the surgical decision is further along in the fertility evaluation process. Male fertility treatment options range from medication, lifestyle adjustments, and microsurgical techniques. It is best to discuss with your doctor the diagnosis and all available treatment options.

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thanks alot for the knowledge been spread out,i appriciate so much.recently i had a surgery on epididymal cystectomy and also testicular torsion.i was told my sperm cord was also long and been anchored.i am getting better just that the affected testis is so thick and scary,but from your write ups and what the Doctors say,it will come down and i hope so.i really thank you all for your write ups and i commend grately on them. Thanks alot once again. Obinna .A
obi - 26-Jul-12 @ 3:44 AM
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