PubMed · 7667988
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C S Gutierrez. 1995. Cryptorchidism.. https://pubmed.ncbi.nlm.nih.gov/7667988/
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PURPOSE: In 1975 the clinical importance of the preperitoneal fascial or secondary internal ring was noted based on procedures performed through the suprainguinal preperitoneal approach. The importance of knowledge of the secondary internal ring in the performance of inguinal hernia repairs, orchiopexies and operations for impalpable testes through the inguinal canal is shown, along with a description of the anatomy of the internal ring and subjacent retroperitoneal connective tissue. MATERIALS AND METHODS: More than 250 consecutive inguinal canal dissections were performed during surgery for inguinal hernia repair, orchiopexy or impalpable testes by a single surgeon using 3.5x magnification. RESULTS: The intraoperative dissections clearly showed the existence of a secondary internal ring, which when opened provided wide access to the retroperitoneal space containing the internal spermatic vessels and vas deferens. CONCLUSIONS: Knowledge of the anatomy of the secondary internal ring is an adjunct to the performance of operations through the inguinal canal.
PURPOSE: We evaluated urogenital anomalies in men with congenital absence of the vas deferens. METHODS AND MATERIALS: A retrospective review was done of 104 subfertile men with congenital absence of the vas deferens (84 bilaterally and 20 unilaterally). RESULTS: Of men with unilateral or bilateral congenital absence of the vas deferens 26 and 11%, respectively, had renal agenesis. Of men with unilateral congenital absence of the vas deferens and infertility 80% had genitourinary anamalies affecting the contralateral testis. No man with congenital absence of the vas deferens and renal anomalies had cystic fibrosis transmembrane-conductance regulator (CFTR) gene mutations detected. CONCLUSIONS: Other urogenital anomalies are common for men with congenital absence of the vas deferens. CFTR gene mutations frequently contribute to maldevelopment of the vas deferens but vasal agenesis can occur without any evidence of CFTR defects. CFTR abnormalities are rarely detected in men with congenital absence of the vas deferens and renal anomalies.