Pelvic Factor

Normal Events

Pelvic Factor Detection

Pelvic Abnormalities
  • Abnormal Male Outflow
  • Vaginal Problems
  • Cervical Problems
  • Uterine Problems
  • Proximal Tubal Disease
  • Bilateral Tubal Ligation
  • Distal Tubal Disease
  • Pelvic Adhesions
  • Endometriosis

Clinical Evaluation

Treatment Options

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The outflow tract causes for abnormalities in sperm include:

Available Drawings: Available Case Reports:

(1) Congenital absence of the vas deferens (CAVD)

CAVD is an uncommon obstructive post testicular lesion that results in a complete absence of sperm (azoospermia). Most men with CAVD have an intact upper one third to two thirds of the epididymis. This allows normally produced sperm to be collected within this storage depot (the epididymis). CAVD occurs in up to 95% of men with cystic fibrosis (a serious autosomal recessive gene disorder of mucus production that affects several organ systems including the lungs). Up to 50% of men who have only one gene mutation for cystic fibrosis (especially the mutation referred to as the delta 508 mutation) will have CAVD. These men are carriers of the cystic fibrosis trait but do not have clinical cystic fibrosis (since this disease requires the presence of 2 gene mutations).

(2) Retrograde ejaculation into the bladder

This can occur if the bladder neck will not close during emission and ejaculation.

An interruption in the sympathetic nerve supply to the area can result in retrograde ejaculation. This may occur with some medications that affect the nervous system, following radical regional surgery that might damage the nerves (like retroperitoneal lymph node dissection for testicular cancer), or with some systemic illnesses that can affect the integrity of these nerves (such as diabetes mellitus and multiple sclerosis). Prior reconstructive bladder surgery can also result in retrograde ejaculation. This may occur after Y-V plasty of the bladder neck at the time of reimplantation of the ureters (popular in the 1960s) or TransUrethral Resection of the Prostate (“TURP”).

(3) Epididymitis

Storage of sperm in an infected epididymis can reduce sperm quality. If suspected, daily ejaculation to reduce the storage time can occasionally be useful.

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