The Epididymis: From Molecules to Clinical Practice. A Comprehensive Survey of the Efferent Ducts, the Epididymis, and the Vas Deferens

Epididymis

Edited by Bernard Robaire, Ph.D. and Barry T. Hinton, Ph.D. New York,

Kluwer Academic/Plenum Publishers, 575 pages, 2002.

The goal of the editors of this text was to develop a comprehensive reference volume regarding the epididymis. They aimed to incorporate all aspects of epididymal biology, including historical background, basic cellular and molecular biology, and clinical issues. The authors have succeeded in developing a text that is broad in scope yet thorough in content. Each chapter is written by expert authors, providing what in aggregate is perhaps the most comprehensive text available regarding the excurrent ductal system.

The first section provides appropriate background, including a historical look at the biology of the excurrent ductal system, evolutionary issues, and a description of the innervation/vascular supply.

The second section is comprised of a series of scientific chapters detailing epididymal epithelial function. These chapters are exceptionally well-written. The accompanying illustrations and photomicrographs are of high quality and aide the reader in navigating this section of the text. Subsequent sections address development, aging, hormonal regulation, and effects of toxicants.

The fifth section consists of a series of chapters addressing spermatozoal changes during epididymal transit. Specific topics detailed include: structural differentiation during post-testicular maturation, plasma membrane composition changes, and acquisition of sperm motility. These reviews are highly technical and collectively serve as an outstanding reference on the subject of post-testicular sperm maturation.

The final series of chapters provide a contemporary overview of "clinical considerations." The clinical issues addressed include management of epididymal dysfunction, impact of obstruction on the epididymis, the epididymis as a target for male contraception, inflammatory conditions of the excurrent ductal system, and cancer of the epididymis. The authors selected for this section are renowned experts, and these chapters as a group are outstanding. The accompanying illustrations and photomicrographs are clear. A more comprehensive overview of sperm extraction techniques and microsurgical reconstruction (vasosvasostomy and epididymovasostomy) would be of significant benefit. I suspect that these may come with subsequent editions, in particular given recent data regarding outcomes with the intussuscepted technique for epididymovasostomy.

In summary, this text has no major flaws. It is an outstanding resource and may indeed be the most comprehensive and contemporary reference regarding the excurrent ductal system in print at this time.

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