Epididymal ligaments: anatomy and function.

Abstract

Three ligaments are described in relation to the epididymis: superior and inferior epididymal, and vasal ligaments. The study was conducted on 38 cadavers and included direct dissection and histologic examination. The superior and inferior epididymal ligaments are triangular folds of the visceral tunica vaginalis, and extend from epididymis to testicle. The superior ligament binds the epididymal head to the testicle, protecting the fine efferent ductules from damage. The inferior ligament fixes body and tail and mesoepididymis; further, it prevents epididymal convolutions from unraveling. The vasal ligament is a fibrous band, which binds the proximal end of the vas to the epididymal tail. It maintains an acute epididymovasal angle. In two cadavers, the inferior epididymal and vasal ligaments were absent. Convolutions of the lower body and tail of the epididymis were unraveled. The mesoepididymis was broad, and the epididymis was freely mobile from side to side; the epididymo-vasal angle was opened. The role of the epididymal and vasal ligaments in fixation of the epididymis, preservation of blood supply to both testicle and epididymis, and preventing unraveling of epididymal convolutions is stressed. Absent epididymal ligaments lead to "mobile epididymis," which may cause infertility.