[Ultrasonographic features of epididymides in obstructive azoospermia].

Objective: To investigate the ultrasonographic features of epididymides in congenital obstructive azoospermia (COA) and acquired obstructive azoospermia (AOA).

Methods: A total of 211 infertile men with obstructive azoospermia were observed by scrotal ultrasonography, and the features of the epididymal ultrasonograms were compared between COA and AOA.

Results: COA exhibited significantly higher rates of ectasia in the epididymal head, cord-like changes, abrupt tapering and absence of the epididymal body and tail than AOA (P < 0.05), while AOA showed markedly higher rates of epididymal body and tail duct ectasia and epididymal inflammatory mass than COA (P < 0.01). Tubular ectasia of the epididymal duct in the head, body and tail were markedly higher in the COA (14 [5.9%], 41 [17.2%] and 20 [8.4%] cases in 236 epididymides) than in the AOA (P < 0.05). Retiform ectasia were markedly higher in the AOA (119 [64.0%], 142 [76.3%] and 109 [58.6%] cases in 186 epididymides) than in the COA (P < 0.05), with statistically significant differences between the two groups (P < 0.05). Ultrasonographically, the epididymides of the COA patients were characterized by irregular ectasia of the epididymal tube with decreased and unclear wall echoes (P < 0.05), and those of the AOA patients by regular ectasia with enhanced wall echoes (P < 0.01).

Conclusion: The ultrasonographic epididymal features of COA are obviously different from those of AOA, which is of important clinical application value for distinguishing the two conditions from each other.