[Congenital or acquired obstructions of the human epididymis: study of the motility of the spermatozoa above the obstruction].
Azoospermia is frequently due to an obstruction of genital pathways. In this work, concerning 22 patients submitted to surgical investigation for sterility, we made a systematic histological investigation of the lesions, and we studied the motility of epididymal spermatozoa. We observed with an unexpected frequency abnormalities of junctions either between seminiferous tubules and efferents ducts - leading to disappearance of rete testis - or between efferent ducts and epididymis. In each case a fibrosis of the epididymis was discovered, the consequence was either an interruption or, more frequently a simple narrowing of the lumen of the epididymal duct. The presence of spermiophages which destroyed all spermatozoa, was also systematically observed. The origin of the lesions (congenital, inflammatory, ischemic... ) could not be determined by simple histological study. Motility of spermatozoa was generally observed in the initial portion of the epididymal duct, but motile spermatozoa were sometimes still observed in the efferent tubules. Motility could be initiated by caffeine while other compounds as albumin, seminal plasma and different organic substrates, had no effects.