Grytsulyak B. V., Glodan O. Ya., Grytsulyak V. B., Dolunko N. P., Polyvkan M. I.
The problem of male infertility does not lose its relevance due to the high sensitivity of testicular parenchyma to the influence of various factors, including surgical trauma of the spermatic cord elements by the hernioplasty, as well as postoperative complications. The structural and functional condition of the epididymis under these circumstances remains poorly investigated, and such data are important, given the fact that in the epididymis there is a maturation process of sperm, which acquire mobility there. Object and methods. The archival histopreparations of 19-year-old men of mature age have served as material for conducting the study. There were also investigated the angiograms of the epididymis in norm and after the plastic of the posterior wall of the inguinal canal by the oblique inguinal hernia and its microslides. There have been investigated archival spermograms of 18 men of the age of 22-35 years in norm, as well as men after hernioplasty of the posterior wall of the inguinal canal by the oblique inguinal hernia, regarding infertility. Histological examination of testicular tissues was performed according to the generally accepted method. Morphological features of the sperm, their mobility, and the Pharris’s fertility index were determined in the spermatogenesis. Statistical analysis of indicators was performed using the software Stat.Soft. Inc., Tusla, OK.USA, Statistica 6. Results and discussion. Angiorentgenological analysis of blood vessels in the epididymis in men of adulthood indicates that its blood supply is carried out by an epididymis artery with a diameter of the lumina 0,65 mm, which is the branch of the testicular artery. In the parenchyma of the epididymis, its small branches form a microcirculatory channel, the outflow of venous blood which is carried out by the epididymis veins into the wicker plexus. Parenchyma of the epididymis is formed by deflection ducts with a diameter of 358,5 μm with a height of pseudo-layered columnar epithelium of 67,8 μm and a duct of a epididymis. After the plastic of the posterior wall of the inguinal canal at the oblique inguinal hernia the arteries and veins of the epididymis, as well as vessels of the microvasculature are significantly twisted, due to the atrophy and enlargement of the connective tissue. The diameter of the ducts decreases to 251,7 μm, and the height of the epithelium decreases to 23,1 μm. In the ejaculate, the concentration of spermatozoa is reduced to 46,3 million/ml, the quantity of normal spermatozoa up to 55,3%, the active mobile forms up to 21,3%, and the number of dead spermatozoa increases to 43,5%, and pathological forms to 44,5%. The Pharris’s fertility index decreases to 76.5 units versus 218.4 units. Conclusions. It was established that after the herniotomy there is a deformation of the arteries, veins of the epididymis and hemomicrovasculature mesh of organ, caused not only by the influence of the contents of the hernial sac on the elements of the spermatic cord, but also after the surgical vascular trauma. The detected atrophy of the parenchyma of the epididymis, significant changes in ejaculate with a down regulation of normal sperm cells, their motor activity, can cause a fertility disorder.
«Bulletin of problems biology and medicine» Issue 2 (144), 2018 year, 298-301 pages, index UDK 612.616-089.844
