Journal of Andrology, Vol. 25, No. 3, May/June 2004
Copyright © American Society of Andrology
The Contractile Wall of the Caput Epididymidis in Men Affected by Congenital or Postinflammatory Obstructive Azoospermia
FIORE PELLICCIONE*,
GIULIANA CORDESCHI*,
VALERIA GIULIANI*,
PIERA D'ABRIZIO*,
STEFANO NECOZIONE*,
LUCIANO NEGRI
,
MARIO MANCINI
,
PATRIZIA SAGONE
,
FELICE FRANCAVILLA*,
GIOVANNI MARIA COLPI
AND
SANDRO FRANCAVILLA*
From the * Andrology Unit, Department of Internal
Medicine, University of L'Aquila (I), and the
Andrology Unit, S. Paolo General Hospital,
Milano, Italy.
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Correspondence to: Prof Sandro Francavilla, Dipartimento di Medicina Interna,
Università dell'Aquila, Via Vetoio, 67100 L'Aquila, Italy (e-mail:
sandrof{at}univaq.it). |
The transport and storage of spermatozoa in the epididymis depend on the
contractile activity of its tubular wall. It is not known what differences
exist in the contractile wall of the human epididymis in cases of obstructive
azoospermia. The contractile wall in the tubules of the caput epididymidis was
analyzed by light microscopy and transmission electron microscopy in 10
azoospermic men, 5 with a bilateral congenital absence of vas deferens (CBAVD)
and 5 with a bilateral postinflammatory congestive obstruction of the
epididymis. Five specimens from the same region of the caput epididymidis,
obtained from fertile men who had undergone an orchidectomy because of
testicular cancer, served as controls. No differences were observed between
congenital and congestive obstructions. The contractile wall in caput tubules
proximal to the obstructed level was strongly thickened when compared with
controls (62.98 ± 5.84 µ; 80.82 ± 7.72 µ vs 19.59 ±
2.23 µ, respectively, for congestive and congenital obstructions vs
controls; P < .0001 vs controls), and the spindle-shaped myoid cells, which
formed the contractile wall in normal cases, were replaced by large smooth
muscle cells (SMCs) that showed features of coexisting contractile and
secretory functions. The former included crowded cytoplasmic bundles of thin
myofilaments (56 nm in diameter) converging to a large number of dense
bodies, numerous micropinocytotic vesicles of the plasma membrane, and a
continuous cell basement membrane. The presence of a developed rough
endoplasmic reticulum and a Golgi complex, associated with the accumulation of
thick layers of pericellular basement membranelike material and ground
substance, was indicative of a secretory phenotype of SMCs. The increased
mechanical forces on the epididymal wall upstream from the obstruction might
eventually activate the differentiation of myoid cells into SMCs, leading to
an altered physiology of the contractile wall that could have possible
clinical relevance in the case of microsurgical epididymovasostomy.
Key words: Congenital absence of vas deferens, human caput epididymidis, smooth muscle cell
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Copyright © 2004 by The American Society of Andrology.