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Absence of the vas deferens may occur unilateral or bilateral, it may be associated with absence of the seminal vesicles or with abnormalities of the urinary tract (Tüttelmann et al, 2008):
Unilateral absence of the vas deferens occurs in 0.6–1%. Bilateral absence of the vas deferens is in 6% the underlying cause of obstructive azoospermia.
Mutations in the CFTR (cystic fibrosis transmembrane conductance regulator) lead to a bilateral absence of the seminal vesicles and/or vasa deferentes. The (pulmonary) manifestation of cystic fibrosis is not obligatory. Numerous different mutations have been described, which can be detected in 80% of men with CBAVD.
Patients with CBAVD without CFTR mutations will have in up to 40% a unilateral renal agenesia. The mechanism for this disorder is unclear.
Unilateral absence of the vas deferens does not cause any complaints. Men with CBAVD suffer from azoospermia and infertility.
Treatment is only necessary for reproduction, which is possible with intracytoplasmic sperm injection. The risk of cystic fibrosis (CF) is increased, genetic diagnosis and counseling can assess the risk individually.
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Deutsche Version: CBAVD
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© Dr. med. Dirk Manski
man...@urologielehrbuch.de