Excurrent duct system of the male turtle Chrysemys picta

The epididymis and efferent duct system of the turtle Chrysemys picta were examined. Seminiferous tubules are drained by a series of ducts that form a rete exterior to the tunica albuginea. The rete is located lateral to the testis and consists of anastamosing tubules of varying diameters, lined by a simple epithelium consisting of squamous to cuboidal cells. The rete is highly vascularized. A series of tubules (efferent ductules) connect the rete to the epididymis proper. The efferent ductules are highly convoluted, running between the epididymal tubules and are of varying diameters. The simple columnar epithelium lining these tubules possesses tight junctions, with every third or fourth cell possessing long cilia that protrude into the lumen. The cytoplasm of these epithelial cells contains abundant mitochondria. In the central portion of the efferent ductule, epithelial cells possess granules that appear to be secreted into the lumen by an apocrine process. The epididymis proper is a single, long, highly convoluted tubule that receives efferent ductules along its entire length. It is lined by a pseudostratified epithelium containing several cell types. The most abundant cell (vesicular cell) lacks cilia, but has a darkly staining apical border due to numerous small vesicles immediately beneath the luminal membrane. The small vesicles appear to fuse with each other basally to form larger vesicles. These cells appear to have an absorptive function, and occasionally sperm are embedded in their cytoplasm. The second-most abundant cell is a basal cell found along the basement membrane. The number of these cells fluctuates throughout the year, being most abundant in late summer and early fall. A small narrow cell with an oval nucleus and darkly staining cytoplasm, extending from the basement membrane to the apical surface, is present in small numbers, particularly in the caudal regions of the epididymis. This cell is frequently found in association with another narrow cell having a rounded nucleus and abundant mitochondria in its cytoplasm.     

Organization of tubules in the human caput epididymidis and the ultrastructure of their epithelia

The structure of the human caput epididymidis was examined by gross morphological and light and electron microscopic techniques. There were at least seven types of tubules, each characterized by a different epithelium. These tubules were connected with one another by at least eight types of junctions to form a network. Most of the caput epididymidis was composed of efferent ducts. Within these, five types of tubules, each with a different ciliated epithelium, were found in different regions; and four types of junctions between the efferent ducts and the epididymal tubule were observed. The efferent ducts left the testis, initially as parallel straight tubules containing both ciliated and non-ciliated cells in an epithelium of irregular height. Each efferent duct then coiled tortuously into lobules that folded over one another. These efferent ducts then branched out as thin tubules to join a network of dark tubules which were lined by a regular epithelium containing prominently vacuolated, non-ciliated cells. These tubules anastomosed via common cavities characterized by a ciliated cuboidal epithelium and sometimes joined tubules exhibiting a non-vacuolated ciliated epithelium. The latter, as well as typical efferent ducts, made connection with the epididymis proper in both end-to-end and end-to-side junctions. In the more distal junctions with the epididymis, the efferent ducts joined to a transitional epididymal ductule before joining to the side of the epididymis proper. Post-junctional epithelia in the beginning of the epididymis occasionally contained patches of cells characteristic of efferent ducts. Tall cells with long stereocilia constituted a discontinuous "initial segment"-like region of the epididymis. This is the most detailed study so far of the epithelia and the tubule organization in the caput epididymidis of any species, and most of the results are reported for the first time for the human. Although the pattern of the tubule network resembles that of some domestic species, the rich variety of epithelia has not been appreciated before.     

Efferent ductules of the fan-throated lizard Sitana ponticeriana Cuvier: light and transmission electron microscopy study

Light microscopy histology of efferent ductules and the ultrastructural organization of their epithelium were studied in the fan‐throated lizard Sitana ponticeriana Cuvier. The ductules of this lizard are extra‐testicular and arise from an extra‐testicular rete testis. A major portion of the ductules is intra‐epididymal and occupies the cephalic end of the epididymis. The ductules differentiate histologically into proximal and distal portions. The epithelium is formed of two major tall columnar cell types, the non‐ciliated and ciliated, and one minor cell type, the basal cells. Dark cells were also identified. The non‐ciliated cells possess microvilli towards the luminal end, tubular coated pits at the bases of the microvilli, coated vesicles in the apical cytoplasm and multivesicular bodies, lysosomes and mitochondria in the supranuclear and perinuclear cytoplasm, which reflects their role in the uptake of the material they are processing. These cells also participate in spermiophagy. The ciliated cells reflect their role in mixing the luminal content and/or its transport to the distal parts of the male tract. The lizard efferent ductules share many features in common with those of mammals and a crocodile and several other features with birds and a turtle. Spermiophagy by the efferent ductules is reported here for the first time in a reptile.     

The postnatal histology of the epididymis in buffalo (Bubalus bubalis).

The epididymis of buffalo is differentiated into 6 regions. The head represents the first 3 regions, the body the 4th region and the tail the 5th and 6th region. At 3-30 weeks, the epithelium is simple high columnar with few basal cells in region I, simple low columnar with few basal cells in region II, pseudostratified low columnar in regions III, IV, V, and pseudostratified low columar in region VI. As age advances, the epithelium increases in height and shows a tendency toward advanced pseudostratification. The basal cells are greater in number in regions III, IV and V than in the other regions of the epididymis. The epithelial cells contain stereocilia in region I at 3 weeks and regions III, IV and V at 30 weeks, whereas they are absent in regions II and VI. The tubules in region I are the smallest in diameter while the tubules in region VI have the largest diameter.     

Gonadotropin-induced luminal formation in the seminiferous tubules and efferent ductules in young frogs: light and electron microscopic study

To clarify the mechanism of fluid secretion in the testes at the time of gonadotropin-induced spermiation, young Rana nigromaculata were used. As a morphological index of fluid secretion, luminal formation of the seminiferous tubules, and efferent ductules were observed. The following changes were seen by the administration of hCG or frog pituitary: first, the luminal formation of the seminiferous tubules was seen; next, tubular expansion became evident, and finally, luminal formation and expansion were observed in the efferent ductules. These changes were preceded by the separation of cell contact among Sertoli cells and of cell contact between Sertoli cells and the cells of efferent ductules only in the center and the swelling of Sertoli cells and cells of efferent ductules. With regard to the flow of fluid at the time of spermiation, the present results indicate the possibility that there is a difference in the ability for fluid secretion between Sertoli cells and the ductule cells.     

Aquaporin-1 and -9 are differentially regulated by oestrogen in the efferent ductule epithelium and initial segment of the epididymis

BACKGROUND INFORMATION: Efferent ductules reabsorb more than 90% of the rete testis fluid, a process that involves ion transporters and AQP (aquaporin) water channels. Oestrogen has been shown to modulate the expression of the ion transporters involved in this activity, but reports of AQP regulation in the male tract have been confounding. To understand better the regulation of AQP1 and AQP9, we investigated their expression in rat efferent ductules and initial segment of the epididymis after treatment with the pure antioestrogen ICI 182,780 or bilateral efferent duct ligation, or castration, followed by hormone replacement. RESULTS: Results show that AQP9 is modulated by oestrogen in the efferent ductule epithelium, but not in the initial segment of the epididymis. DHT (5alpha-dihydrotestosterone) also modulated AQP9 in efferent ductules. AQP9 was down-regulated by the antioestrogen in efferent ductules on day 45 post-treatment, which occurred before the non-ciliated cells had shown significant loss of microvilli. DHT, but not oestradiol, modulated AQP9 expression in the initial segment of the epididymis. In contrast, testosterone, DHT, oestrogen or the antioestrogen did not alter AQP1 staining, indicating constitutive expression of AQP1 in the efferent ductule epithelium. AQP1 expression was induced in peritubular cells of efferent ductules and in the initial segment of the epididymis after castration and long-term treatment with the antioestrogen. Although peritubular AQP1 staining in efferent ductules was partially reversed by the androgens, it was not reversed after any treatment in the initial segment of the epididymis. CONCLUSIONS: These results demonstrate that efferent ductules are unique in requiring both oestrogen and androgen to regulate an important mediator of fluid reabsorption, whereas the initial segment is dependent only on androgen stimulation.     

Immunolocalization of androgen and vitamin D receptors in the epididymis of mature ram (Ovis aries)

This study illustrated the immunohistochemical distribution of androgen and vitamin D receptors of epididymis in 20 sexually mature ram (Rahmani breed) with average age ranged from (2^_4) years and average weight ranged from (50^_65kg). Androgen receptor was localized in the cytoplasm of both ciliated and non ciliated cells of efferent ductules, besides the principal cells via the entire epididymal duct. The principal cells of both corpus and proximal cauda epididymis showed the highest immunoreactivity to androgen receptors. Furthermore, vitamin D receptor was localized in the cytoplasm of all epithelium of the efferent ductules besides principal cells of all epididymal regions, however the immunoreaction was significantly higher in the efferent ductules, distal caput and distal cauda epididymis. In conclusion, these results suggest that the function of ram epididymis is regulated by both androgen and Vitamin D.     

FGF8 is essential for formation of the ductal system in the male reproductive tract

During development of the urogenital tract, fibroblast growth factor 8 (Fgf8) is expressed in mesonephric tubules, but its role in this tissue remains undefined. An evaluation of previously generated T-Cre-mediated Fgf8-deficient mice (T-Cre; Fgf8(flox/Δ2,3) mice), which lack Fgf8 expression in the mesoderm, revealed that the cranial region of the Wolffian duct degenerated prematurely and the cranial mesonephric tubules were missing. As a result, the epididymis, vas deferens and efferent ductules were largely absent in mutant mice. Rarb2-Cre was used to eliminate FGF8 from the mesonephric tubules but to allow expression in the adjacent somites. These mutants retained the cranial end of the Wolffian duct and formed the epididymis and vas deferens, but failed to elaborate the efferent ductules, indicating that Fgf8 expression by the mesonephric tubules is required specifically for the formation of the ductules. Ret knockout mice do not form the ureteric bud, a caudal outgrowth of the Wolffian duct and progenitor for the collecting duct network in the kidney, but they do develop the cranial end normally. This indicates that Fgf8, but not Ret, expression is essential to the outgrowth of the cranial mesonephric tubules from the Wolffian duct and to the development of major portions of the sex accessory tissues in the male reproductive tract. Mechanistically, FGF8 functions upstream of Lhx1 expression in forming the nephron, and analysis of Fgf8 mutants similarly shows deficient Lhx1 expression in the mesonephric tubules. These results demonstrate a multifocal requirement for FGF8 in establishing the male reproductive tract ducts and implicate Lhx1 signaling in tubule elongation.     

The histological changes in the testis, epididymis and prostate gland of the red-bellied tree squirrel, Callosciurus erythraeus, during the growth and reproductive cycle

The male reproductive glands of the red-bellied tree squirrel, Callosciurus erythraeus, in the infantile, and prepubertal males, as well as sexually functional, degenerating and redeveloping adults were studied histologically. In the infant, testes are characterized with solid seminiferous tubules filled with primordial germ cells and Sertoli cells. Interstitial cells are sparse. The prostate is composed of condensed cell cords grouped into lobules dispersed with interlobular tissues rich in fibroblasts. In the epididymis the highly convoluted tubule is lined with a simple cuboidal or columnar epithelium and thin smooth musculature without. In the prepubertal male, germ cells are engaged actively in mitosis. Primary spermatocytes are readily recognized. Leydig cells appear in groups in the interstitial tissue. In the prostate, cell cords become highly branched and collecting tubules make their appearance. The tubules in the epididymis are enlarged in diameter but their peripheral musculature becomes thinner. In functional males, meiosis is active and bundles of spermatozoa are scattered along the central lumen. Leydig cells have their cytoplasm highly enriched. The prostate is in the secretory phase. The tubule in the epididymis is filled with sperm. In the degenerating adult, meiosis is interrupted and necrotic germ cells are detached from germinal epithelium. In the prostate, secretory and collecting ducts are eventually reduced to condensed lobules separated by interlobular fibrous tissue. The tubule in the epididymis often fills with necrotic germ cells but no sperm. In the redeveloping adult, the histology of the testes, prostate and epididymis is similar to that of the prepubertal male. However, there is more fibrous tissue in the interlobular septa in the prostate gland and thick musculature at the periphery of the tubule in the epididymis.     

Observations on the anterior testicular ducts in snakes with emphasis on sea snakes and ultrastructure in the yellow‐bellied sea snake,Pelamis platurus

The anterior testicular ducts of squamates transport sperm from the seminiferous tubules to the ductus deferens. These ducts consist of the rete testis, ductuli efferentes, and ductus epididymis. Many histological and a few ultrastructural studies of the squamate reproductive tract exist, but none concern the Hydrophiidae, the sea snakes and sea kraits. In this study, we describe the anterior testicular ducts of six species of hydrophiid snakes as well as representatives from the Elapidae, Homolapsidae, Leptotyphlopidae, and Uropeltidae. In addition, we examine the ultrastructure of these ducts in the yellow‐bellied Sea Snake, Pelamis platurus, only the third such study on snakes. The anterior testicular ducts are similar in histology in all species examined. The rete testis is simple squamous or cuboidal epithelium and transports sperm from the seminiferous tubules to the ductuli efferentes in the extratesticular epididymal sheath. The ductuli efferentes are branched, convoluted tubules composed of simple cuboidal, ciliated epithelium, and many species possess periodic acid‐Schiff+ granules in the cytoplasm. The ductus epididymis at the light microscopy level appears composed of pseudostratified columnar epithelium. At the ultrastructural level, the rete testis and ductuli efferentes of P. platurus possess numerous small coated vesicles and lack secretory vacuoles. Apocrine blebs in the ductuli efferentes, however, indicate secretory activity, possibly by a constitutive pathway. Ultrastructure reveals three types of cells in the ductus epididymis of P. platurus: columnar principal cells, squamous basal cells, and mitochondria‐rich apical cells. This is the first report of apical cells in a snake. In addition, occasional principal cells possess a single cilium, which has not been reported in reptiles previously but is known in some birds. Finally, the ductus epididymis of P. platurus differs from other snakes that have been studied in possession of apical, biphasic secretory vacuoles. All of the proximal ducts are characterized by widening of adjacent plasma membranes into wide intercellular spaces, especially between the principal cells of the ductus epididymis. Our results contribute to a larger, collaborative study of the evolution of the squamate reproductive tract and to the potential for utilizing cellular characters in future phylogenetic inferences. J. Morphol. 2012. © 2011 Wiley Periodicals, Inc.     

Differential expression of estrogen receptors alpha and beta in the reproductive tracts of adult male dogs and cats

Expression of estrogen receptors (ERs) in the reproductive tracts of adult male dogs and cats has not been reported. In the present study, ERalpha and ERbeta were localized by immunohistochemistry using ER-specific antibodies. ERalpha was found in interstitial cells and peritubular myoid cells in the dog testis, but only in interstitial cells of the cat. In rete testis of the dog, epithelial cells were positive for ERalpha staining, but in the cat, rete testis epithelium was only weakly positive. In efferent ductules of the dog, both ciliated and nonciliated cells stained intensely positive. In the cat, ciliated epithelial cells were less stained than nonciliated epithelial cells. Epithelial cells in dog epididymis and vas deferens were negative for ERalpha. In the cat, except for the initial region of caput epididymis, ERalpha staining was positive in the epithelial cells of epididymis and vas deferens. Multiple cell types of dog and cat testes stained positive for ERbeta. In rete testis and efferent ductules, epithelial cells were weakly positive for ERbeta. Most epithelial cells of the epididymis and vas deferens exhibited a strong positive staining in both species. In addition, double staining was used to demonstrate colocalization of both ERalpha and ERbeta in efferent ductules of both species. The specificity of antibodies was demonstrated by Western blot analysis. This study reveals a differential localization of ERalpha and ERbeta in male dog and cat reproductive tracts, demonstrating more intensive expression of ERbeta than ERalpha. However, as in other species, the efferent ductules remained the region of highest concentration of ERalpha.     

Immunocytochemical localization of lipocalin-type prostaglandin D synthase in the bull testis and epididymis and on ejaculated sperm

Previously, we identified a 26-kDa fertility-associated protein in bull seminal plasma as lipocalin-type prostaglandin D synthase. The objective of the present study was to immunohistochemically localize this enzyme to the various cell types within the bull testis and seven subsegments of the epididymis, and on ejaculated sperm in order to gain further insight into its potential function in male reproduction. In the testis, immunoperoxidase staining was localized within the elongating spermatids and Sertoli cells of the seminiferous tubules, varying with the stage of the spermatogenic cycle. The highest level of staining occurred during stages III-VII. The cuboidal epithelial cells of the rete testis and efferent ducts were also immunoreactive. Expression of lipocalin-type prostaglandin D synthase was not uniform in the seven epididymal subsegments, suggesting a possible role in sperm maturation. In all epididymal regions, expression was limited to the epithelial principal cells; no immunoreactivity was apparent in other cell types. Lipocalin-type prostaglandin D synthase was strikingly localized in the caput epididymidis, while moderate to weak staining was observed in the remainder of the epididymis. Droplets of reaction product observed within the lumen increased progressively from the caput to cauda. Using fluorescence microscopy, we also localized lipocalin-type prostaglandin D synthase to the apical ridge of the acrosome on ejaculated sperm.     

Ultrastructure of the reproductive system of the black swamp snake (Seminatrix pygaea). VI. Anterior testicular ducts and their nomenclature

In this study, the anterior testicular ducts of the North American natricine snake Seminatrix pygaea are described using light and electron microscopy. From the seminiferous tubules, the rete testis passes into the epididymal sheath, a structure along the medial border of the testis heavily invested with collagen fibers. The rete testis consists of simple, nonciliated cuboidal epithelium (principal cells). The intratesticular ducts of the rete testis are narrow (50–70 μm) at their junction with the seminiferous tubules, widen (80–100 μm) as they extend extratesticularly, and divide into smaller branches as they anastomose with the next tubules, the ductuli efferentes. The ductuli efferentes are lined by simple cuboidal epithelium but possess nonciliated principal cells as well as ciliated cells. These are the only ducts in the male reproductive system with ciliated cells. The ductuli efferentes are narrow (25–45 μm), divide into numerous branches, and are highly convoluted. The ductus epididymis is the largest duct in diameter (240–330 μm), and the diameter widens and the epithelium thins posteriorly. The ductus epididymis is lined by nonciliated, columnar principal cells and basal cells. No regional differences in the ductus epididymis are apparent. Ultrastructural evidence suggests that all of the nonciliated principal cells in each of the anterior testicular ducts function in both absorption and secretion. Absorption occurs via small endocytic vesicles, some of which appear coated. Secretion is by a constitutive pathway in which small vesicles and a flocculent material are released via a merocrine process or through the formation of apocrine blebs. The secretory product is a glycoprotein. Overall, the characteristics of the anterior testicular ducts of this snake are concordant with those of other amniotes, and the traditional names used for snakes are changed to conform with those used for other sauropsids and mammals. J. Morphol., 2010. © 2009 Wiley‐Liss, Inc.     

Expression of constitutively active Notch1 in male genital tracts results in ectopic growth and blockage of efferent ducts, epididymal hyperplasia and sterility

The Notch signaling pathway is involved in a variety of developmental processes. Here, we characterize the phenotypes developing in the reproductive organs of male transgenic (Tg) mice constitutively expressing the activated mouse Notch1 intracellular domain (Notch1(intra)) under the regulatory control of the mouse mammary tumor virus (MMTV) long terminal repeat (LTR). Tg expression was detected in testis, vas deferens and epididymis by Northern blot analysis. In situ hybridization with a Notch1-specific probe lacked sensitivity to detect expression in normal-appearing cells, but demonstrated expression in hyperplastic epithelial cells of the vas deferens, epididymis and efferent ducts. Tg males from three independent founder lines were sterile. Histological analysis of reproductive organs of young Tg males (postnatal ages 8 and 21) showed no difference compared to those of non-Tg males. In contrast, in adult Tg mice from day 38 onwards, the efferent ducts, the vas deferens and most epididymal segments revealed bilateral epithelial cell hyperplasia with absence of fully differentiated epithelial cells. Electron microscopy confirmed the uniformly undifferentiated state of these cells. Immunohistochemistry with anti-PCNA antibody also revealed enhanced proliferation of Tg epididymis. In adult Tg testis, the different generations of germ cells of seminiferous tubules appeared normal, although some tubules were highly dilated and revealed an absence of early and/or late spermatids. The epithelial cells of the Tg tubuli recti and rete testis were not abnormal, but the rete testis was highly dilated and contained numerous spermatozoa, suggesting a downstream blockage. Consistent with a blockage of efferent ducts often seen at the rete testis/efferent duct interface, spermatozoa were absent in epididymis of all adult Tg mice and in all highly hyperplastic efferent duct tubules of these Tg mice. Such a blockage was visualized by injection of Evans blue dye into the rete testis lumen. Finally, the presence of ectopic hyperplastic efferent duct tubules was observed within the testicular parenchyma itself, outside their normal territory, suggesting that Notch1 signaling is involved in the establishment of these borders. This phenotype seems to represent a novel developmental defect in mammals. Together, these results show that constitutive Notch1 signaling significantly affects the development of male reproductive organs.     

Isolation technique and identification of epithelial cells from efferent ductules of the rat epididymis

A method has been developed for isolation of cells from the efferent ductules of the rat epididymis to obtain a population of epithelial cells. The technique depends on a transfer of segments of the ductules into a new isolation medium and gradual purification from fat cells, fibroblasts, collagen fibres and smooth muscle cells. Segments of the ductules so isolated were further separated into single cells or their aggregates. The mode of isolation applied allowed to obtain morphologically unchanged and functionally fully efficient cells. When transferred to culture they rapidly formed a single layer and further developed into a multi-layer culture. The cells divide and preserve their ability of producing secretion. They react to the absence of androgenous hormones by a considerable depression of the number of mitotic divisions and reduction of their secretion.     

Expression of estrogen receptor alpha switches off secretory activity in the epididymal channel of the lizard Podarcis sicula

The epididymis in the male reproductive tract allows the survival, viability, and storage of spermatozoa from the testis. In the lizard Podarcis sicula, the epididymis can be regionalized to an initial segment called the caput that comprises the efferent ductules, followed by the middle and terminal segments, respectively termed the corpus and cauda. By means of in situ hybridization and immunocytochemistry, we analyzed the expression of the estrogen receptors of the alpha and beta type (ERα and ERβ) in Podarcis to test the responsiveness of the epididymal regions to estrogen in the annual reproductive cycle of this seasonal breeder. The results show that the efferent ductules and the cauda always express both ERα and ERβ throughout the year. In the corpus, the expression of ERα takes place only at the end of the mating period and continues in the non-reproductive season whereas ERβ is expressed in all phases of the cycle. During the mating season, the cells of the corpus are engaged in massive secretory activity and do not express ERα. Experimental administration of E(2) during this season does not change the expression of ERβ, nor does it affect the efferent ductules and cauda; instead, it inhibits the secretory activity in the corpus and induces the expression of ERα. Taken together, our findings suggest that in the epididymis of Podarcis, the expression of ERα may act as a switch for the secretory activity of the epididymal corpus.     

Ion transporters for fluid reabsorption in the rooster (Gallus domesticus) epididymal region

Testicular fluid is highly condensed during its passage through the epididymal region in the avian species. In the present study, major ion transporters that are responsible for condensation mainly by water resorption in the reproductive tract as identified in the mammalian epididymis were localized within the rooster (Gallus domesticus) epididymis by immunohistochemistry. The results show that the efferent ductule epithelium expressed sodium-potassium ATPase (Na(+),K(+)-ATPase), carbonic anhydrase II (CAII) and sodium hydrogen exchanger isoform 3 (NHE3) and that the connecting ductule and epididymal duct epithelia expressed Na(+),K(+)-ATPase and CAII. These data suggest that a model proposed for reabsorption in mammalian efferent ductules can be applied to avian efferent ductules.     

Histopathology of the male reproductive system induced by the fungicide benomyl

Benomyl is an effective fungicide that has been in use for many years. This chemical and its primary metabolite, carbendazim, are microtubule poisons that are relatively nontoxic to all mammalian organs, except for the male reproductive system. Its primary effects, at moderate to low dosages, are on the testis, where it causes sloughing of germ cells in a stage-dependent manner. Sloughing is caused by the effects of the chemical on microtubules and intermediate filaments of the Sertoli cell. These effects spread to dividing germ cells and also lead to abnormal development of the head of elongating spermatids. At higher dosages, it causes occlusion of the efferent ducts, blocking passage of sperm from the rete testis to epididymis. The mechanism of occlusion appears to be related to fluid reabsorption, sperm stasis, followed by leukocyte chemotaxis, sperm granulomas, fibrosis and often the formation of abnormal microcanals. The occlusion results in a rapid swelling of the testis and ultimately seminiferous tubular atrophy and infertility. In conclusion, studies that reveal long term testicular atrophy following chronic or subchronic exposure to a toxicant should be re-examined for histopathological lesions in the efferent ductules and head of the epididymis. Lesions in the male track that cause blockage may induce permanent testicular damage and a decrease in sperm production.