Evaluation of the congenital absence of the vas deferens with magnetic resonance imaging: preliminary findings

PURPOSE: To date, no study provides definitive evidence for the pathogenesis of congenital absence of the vas deferens (CAVD). This study aims to evaluate the vas deferens (VD), particularly the intra-abdominal part and accompanying seminal vesicle (SV) pathologies, in search of an explanation for the pathogenesis of the disease using magnetic resonance imaging (MRI) in patients clinically diagnosed with CAVD. METHODS: MRI scans of patients admitted to our center with clinically diagnosed unilateral CAVD (CUAVD) or bilateral CAVD (CBAVD) in the infertility clinic were retrospectively evaluated. SV hypoplasia, SV agenesis, the distal part of the VD close to the ampulla, and the intra-abdominal part of the VD were investigated. Additionally, the association of CAVD and SV pathologies was assessed. RESULTS: Clinically and confirmed with scrotal sonography by evaluating the proximal part of the VD, 32 patients (62.7%) had CBAVD, and 19 patients (37.3) had CUAVD. In MRI, the intra-abdominal part of the VD was visible in 52.9% of all patients. The association between the intra-abdominal part of the VD and CAVD was statistically significant in the CBAVD patient group compared with the CUAVD group (Bonferroni-adjusted P value = 0.006). The intra-abdominal part of the VD dilatation is a new finding in CAVD and was not found in patients with CUAVD. Only 2 out of 51 patients (3.9%) had a standard SV. CONCLUSION: In the assessment of CAVD and accompanying SV pathologies, detailed findings are obtained by MRI even in the evaluation of the intra-abdominal part of the VD. Preliminary findings in this study are consistent with the theory of acquired vasal agenesis in CBAVD. CLINICAL SIGNIFICANCE: The detailed findings of an MRI may contribute to a better understanding of the disease.