DEFERENT DUCT

From Big Medical Encyclopedia

DEFERENT DUCT [ductus deferens (PNA, JNA, BNA); synonym vas deferens (Cooperi)] — the pair channel which is direct continuation of a channel of an epididymis, coming to an end at the place of merge to a secretory channel of a seed bubble. Its functional value consists in carrying out spermatozoa (see) that is promoted by peristaltic reductions of a wall of S. of the item

Embryology

to S. of the item forms on the 3rd month of an antenatal life from mezonefralyyugo (volfova) of a channel kaudalny an epididymis. Around a channel the smooth muscle cover is formed, edges becomes three-layered (internal and outside layers — longitudinal, average — circular). Then S. the item is outside surrounded with a connective tissue extima.

Anatomy

Fig. 1. The diagrammatic representation of topography of a deferent duct (a sagittal section through a bladder, a pubic symphysis and generative organs): 1 — a bladder; 2 — a pubic symphysis; 3 — a prostate; 4 — an urethra; 5 — a penis; 6 — a small egg; 7 — a scrotum; 8 — an epididymis; 9 — a deferent duct; 10 — bulbouretralny gland; 11 — an ejaculatory channel; 12 — a secretory channel of a seed bubble; 13 — a seed bubble; 14 — an ampoule of a deferent duct.

The page of the item has an appearance of a cord of whitish color. Length of its from 45 to 50 cm, diameter apprx. 3 mm, diameter of a gleam is 0,2 — 0,5 mm. The left S. is slightly longer than the item, than right, owing to lower provision of the left small egg. The initial, shortest department of S. of the item, is behind small egg (see), medialny its appendage is also called a yaichkovy part (pars testicularis). The following part (pars funicularis), rising vertically up, takes place in structure seed cord (see) behind from its vessels also reaches an outside abdominal ring. Further he enters in pakhovy channel (see) where its inguinal part (pars inguinalis) is located. The called departments make free part C. of the item. Having gone out of the inguinal channel through a deep abdominal ring, S. of the item goes zabryushinno on a sidewall of a small pelvis down and kzad — a pelvic part (pars pelvi-pas). On the way of S. the item bends around the lower epigastriß artery from the lateral party, crosses with an outside ileal artery and a vein. Then goes between a bladder (see) and rectum (see), crosses ureter (see) further passes over a prostate near the same channel of the opposite side. This final department of S. of the item is expanded veretenoobrazno, forming an ampoule of a deferent duct (ampulla ductus deferentis). Length of an ampoule is equal to 30 — 40 mm, the greatest cross sectional dimension reaches it 10 mm. Ampoules of the right and left deferent ducts meet at an acute angle (50 — 65 °) with secretory channels seed bubbles (see). In the bottom the ampoule is gradually narrowed and at the level of the upper edge of a prostate connects to a secretory channel of a seed bubble, forming an ejaculatory channel (ductus ejaculatorius), extent to-rogo makes apprx. 20 mm, width of a gleam from 0,8 — 1 mm in an initial part to 0,2 — 0,3 mm at the place of falling into an urethra (fig. 1).

Fig. 2. Diagrammatic representation of a microscopic structure of a deferent duct (cross section): 1 — a gleam of a deferent duct; 2 — an epithelium; 3 — an inner longitudinal layer of a muscular coat; 4 — an average circular layer of a muscular coat; 5 — an outside longitudinal layer of a muscular coat; 6 — an extima.

S.'s wall of the item consists of three covers. Outside, the extima (tunica adventitia) is rich with elastic fibers. More deeply strongly developed muscular coat (tunica muscularis) is located, edges consists from outside and internal longitudinal and average circular layers of smooth muscle cells. The muscular coat gives to S.'s wall of the item a dense consistence. In S.'s ampoule of the item muscular layers are expressed less clearly. The mucous membrane (tunica mucosa) C. of the item is covered with a two-row cylindrical epithelium, forms 3 — 6 longitudinal folds therefore on cross section the gleam of a channel has the star-shaped form (fig. 2). In a mucous membrane of an ampoule there are numerous bukhtovidny protrusions — diverticulums of an ampoule (diverticula ampullae) with the glands located in their thickness allocating the secret promoting the movement of spermatozoa.

The page of the item is supplied with blood from the ascending and descending branches of an artery of a deferent duct (and. ductus deferentis). The ampoule receives blood on branches of average pryamokishechny and lower vesical arteries (a. rectalis media et a. vesi-calis inferior). A venous blood flows on the veins of the same name in system of an internal ileal vein (v. iliaca interna). The lymph drainage is carried out in internal ileal limf, nodes (nodi lymphatici iliaci interni). The village of the item receives an innervation from a texture of a deferent duct (plexus deferentialis) formed by sympathetic and parasympathetic fibers of the lower hypogastric texture (plexus hypogastricus inf.).

Methods of inspection

At a palpation establish lack or S.'s presence of the item, define its consistence, existence of morbidity. S. is normal the item is easily probed among elements of a seed cord in the form of a dense mobile, painless tyazh. S.'s passability of the item is investigated by a X-ray contrast method (see. Vezikulografiya ). A contrast agent is entered by a puncture of free part C. of the item a fine needle (see. Vasopuncture ), directing a needle towards an urethra.

Pathology

in case of an agenesia of a small egg (see) or cryptorchism (see) total or partial absence of S. of the item is observed; also inborn obliteration of its gleam is possible.

The isolated S.'s damages by the item practically do not meet. As a rule, they are combined with damages of a seed cord and other bodies of a scrotum (a small egg, an epididymis). Damages can be closed and opened. The closed damages result from direct influence (blow) more often. Bruises, crushes, S.'s ruptures of the item usually are followed by sharp pain, hemorrhage in hypodermic cellulose and in fabric of a seed cord, a swelling and cyanotic coloring of skin. The palpation at the same time causes sharp pain. Can be complications at S.'s damage by the item phlegmon (see) and an orchiepididymitis (see. Orchitis , Epididymite ).

Directly after an injury recommend rest, cold for the field of damage, antibacterial and anesthetics. Further heat in the form of the warming compresses and other thermal procedures is shown.

Open damages of S. of the item are possible at bullet, cut, avulsive wounds scrotums (see), inguinal area (see), basin (see), usually happen combined. Meet more often in wartime. Treatment operational. At small defect of S. of the item imposing of an anastomosis the end in the end and recovery of passability of S. of the item is possible (see. Vasovasostomy ).

The result of damages of S. p, depends on the nature of an injury, existence of complications. When S.'s integrity of the item is not broken, usually in 2 — 3 weeks there occurs recovery. If S.'s rupture of the item takes place, then afterwards there occurs cicatricial narrowing or an obliteration of its gleam. Sometimes sperm-totsele forms (see). Bilateral damage of S. of the item with disturbance of passability leads to infertility (see).

From diseases S.'s inflammation of the item most often meets — deferentitis (see); development of an inflammation only in distal department of S. of the item — in its ampoule is possible (ampullitis). On a wedge, a picture the ampullitis is similar to a deferentitis. The elements of a seed cord surrounding S. with the item are, as a rule, involved in inflammatory process (e.g., a seminal hillock). The disease is quite often combined with orchitis (see), epididymite (see), prostatitis (see), cystitis (see).

Tumors, coming from S. of the item, meet extremely seldom. More often than S. the item is involved in tumoral process for the second time at localization of primary center in the next bodies or elements of a seed cord.

Operations — see. Vasovasostomy , Vasoligation , Vasoresection , Vasotomy .



Bibliography: Alayev A. N. Ampoules of deferent ducts in the x-ray image, in book: A structure, blood supply and an innervation of internals, under the editorship of V. S. Yurov, etc., page 142, Stalingrad, 1957; e x m and B. S N. Nonspecific epididymite, M., 1963, bibliogr.; Mineral tar of stalemates about a cue I. D., Revazov V. G. and Bykova N. A. Comparative assessment of methods of sewing together of a deferent duct, Urol. and nave-rol., No. 2, page 52, 1977; Operational surgery and topographical anatomy, under the editorship of V. V. Kovanov, page 209, M., 1978; Petten B. M. Embryology of the person, the lane with English, page 562, M., 1959; The Guide to clinical urology, under the editorship of A. Ya. Pytel, M., 1970; Stepanov V. N. Inborn bilateral lack of deferent ducts — the rare reason of male infertility, Urology, No. 5, page 54, 1964; H at x r and e the Tax Code about D. A. and the Cradle And. B. The atlas of operations on bodies of urinogenital system, M., 1972; Boeminghaus H. Beitrag zur Physiologie des Yas deferens, Arch. klin. Chir., Bd 139, S. 563, 1926.


Yu. D. Glukhov; V. Ya. Bocharov (An.).

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