Vas Deferens Stones: Symptoms and Treatment Options

Vas deferens stones are relatively rare in clinical practice and are more commonly found in young and middle-aged men. These stones can form due to a lack of proteolytic enzymes in the semen. Interestingly, some patients may not experience any noticeable symptoms, while others may encounter issues such as hematospermia (blood in semen), pain during ejaculation, or discomfort during urination. A definitive diagnosis is usually made through imaging techniques like non-contrast multi-slice spiral CT or ultrasound.

When stones are present within the vas deferens, they are typically stationary, which explains why some individuals may not feel any discomfort. However, if the stones are large or have sharp protrusions, they can cause mucosal damage and bleeding inside the vas deferens, resulting in hematospermia during ejaculation. The hardness or irregular shape of the stones may also lead to movement during ejaculation, irritating the surrounding mucosal nerves and causing varying degrees of pain. In some cases, this condition may also lead to urinary discomfort.

In terms of treatment, surgical intervention is often considered for vas deferens stones. Procedures are typically performed with the patient in the lithotomy position under combined or general anesthesia. One modern approach involves the use of holmium laser to fragment and flush out the stones. For smaller stones, minimally invasive techniques such as stone forceps or basket retrieval may be effective. The choice of treatment depends on the size, location, and composition of the stones, as well as the patient's overall health and symptoms.