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Cardiology13 papers

Carbuncle of vas deferens

Last edited: 4/23/2026

Overview

Carbuncle of the vas deferens, though not explicitly defined in the provided abstracts, can be inferred as the presence of characteristic tortuous vasal vessels of normal caliber in the spermatic cord in the context of congenital bilateral absence of the vas deferens (CBAVD). This finding is observed intraoperatively during varicocelectomy procedures 1.

Diagnosis

  • Key Diagnostic Criteria: Presence of dilated internal and external spermatic veins, absence of the vas deferens.
  • Recommended Tests:
    • - Physical examination focusing on varicocele palpation. - Hormonal evaluation to assess for testicular hypotrophy or abnormal hormonal profiles. - Genetic testing for cystic fibrosis transmembrane conductance regulator (CFTR) mutations indicative of CBAVD. - Renal ultrasonography to rule out associated renal anomalies.
  • Grading: Varicocele grading (I-III) based on palpation findings 1.

    • Management

  • First-Line Treatments:
    • - Microsurgical subinguinal varicocelectomy for symptomatic relief or to address testicular hypotrophy.
  • Adjunctive Treatments:
    • - Microsurgical epididymal sperm aspiration and cryopreservation for potential fertility preservation 1.

    Special Populations

  • CBAVD and Varicocele Repair: Varicocele repair can be performed in men with CBAVD, with careful intraoperative identification of vasal vessels 1.

    • Key Recommendations

  • Perform thorough preoperative evaluation including physical examination, hormonal assessment, genetic testing, and renal ultrasonography in men with CBAVD undergoing varicocelectomy 1. (Evidence: Moderate)
  • Intraoperative identification and preservation of characteristic tortuous vasal vessels should be considered during varicocelectomy in CBAVD patients 1. (Evidence: Moderate)
  • Microsurgical subinguinal varicocelectomy is recommended for symptomatic varicoceles or to manage testicular hypotrophy in men with CBAVD 1. (Evidence: Moderate)

    • References

    1 Raman JD, Goldstein M. The presence of vasal vessels in men with congenital bilateral absence of the vas deferens. The Journal of urology 2004. link

    Original source

    1. [1]
      The presence of vasal vessels in men with congenital bilateral absence of the vas deferens. — Raman JD, Goldstein M The Journal of urology (2004)
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