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Urology  (Expert Forum)
 | 
ABSENCE OF VAS DEFRENS
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

ABSENCE OF VAS DEFRENS

by ANON__0__0, Jul 24, 1998 12:00AM
  WELL I HAD A TRANS RECTAL ULTRA SOUND DONE AND
   HAVE THE REPORT SUGGESTIVE OF   OF HAVING 2 CYSTIC WELL DEFINED
  ROUNDED AREA IN THE REGION OF VERU MONTANUM SUGGESTING CYSTIC DELATATION OF
  EJACULATORY DUCTS IN THE REGION OF VERU
  THE AMPULLA OF VAS DEFRENS IS NOT WELL SEEN SUGGESTIVE OF CONGENITAL
  ABSENCE/ATROPHY.
  AND THE SEMINAL VESICLES ARE MARKEDLY SMALLER IN SIZE BARELY VISUALIZED AS
  STREAKY SOFT TISSUE
  BOTH THE TESTIS AND EPIDIDYMIS ARE NORMAL IN SIZE  AND APPEARANCE THE PROSTATE IS
  ALSO NORMAL, CENTRAL ZONE IS ALOS NORMAL
  MY SEXUAL FUNCTION/DRIVE  AND ERECTION IS GOOD HOWEVER THE PENIS IS A LITTLE BIT CURVED
  UPWARDS WHEN FULLY ERECT
  HOWEVER THERE IS VERY LITTLE FLUID WHICH COMES OUT DURING EJACULATION
  THIS HAS HAPPENED SINCE THE LAST FEW YEARS IT WAS QUITE A LOT
   MORE BEFORE NOW IT IS ONLY .2ML WHICH JUST SEEMS PROSTATE FLUID.
  THE HORMONAL TEST SHOWED F.SH 1.8MIU/ML, L.H 2.6MIU/ML, TESTOSTERONE 3.8NG/ML AND
  PROLACTIN 14.0NG/ML.
  WHAT I WOULD LIKE TO KNOW.
   1)IS IT POSSIBLE THAT MY BOLUME OF SEMEN CAN GO UP AS  I FEEL IT IS LESS
  SATISFYING FOR ME AND MY WIFE OR IS IT JUST PSYCHOLOGICAL PLS ADV
  2) DO I NEED ANY FURTHER TEST POSSIBLE TO CONFIRM THE DIAGNOSIS
  3) IS IT POSSIBLE THROUGH ANY SURGERY ETC THINGS CAN BE CORRECTED
  4) IF ANY MEDICINE CAN CURE AND IS THE PENIS BEING A LITTLE BIT CURVED UPWRDS
  NORMAL
===========================================================================

Dear Anon,
Absence of vas deferens on both sides is a congenital condition which is seen in approximately 1.4% of males without sperm.  Other associated findings may include seminal vesicles which might be atrophic and hypoplastic(poorly developed/small) and nonfunctional or completely absent.  Further, semen volume is low and semen tends to be acidic. On physical exam , the vas deferens cannot be felt(nonpalpable) usually.  The ultrasound findings usually shows absent or very poorly developed seminal vesicles.  It appears that you have most of these findings.
To answer your questions:
1) Sexual satisfaction is in great part a subjective experience by both parteners, which could be affected by many different stimuli.  Low semen volume may be viewed as such stimulus in your case, and should not be viewed as a form of sexual inadequacy or dysfunction.  Furthermore if your seminal vesicles and vas deferens were to be intact , a potential resection of the cystic dilations found at level of your veru could help with your semen volume.
2) You need a full evaluation and physical exam by a urologist.  He may decide to do other test/studies.
3) Depending on fidings by a urologist corrective measures could be taken, as I described in #1 above.
4) No medications are known to help with your particular condition.  Further, a small amount of upward curve in a penis is not abnomal, especially if you do not experince any difficulty with pain or penetration during intercourse.  Otherwise, you should discuss this with a urologist.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians’ notes and lab test results that you  may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely,
HFHS M.D.-BE
*Keyword: Seminal vesicle





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