title: Unilateral obstruction of the vas deferens caused by childhood inguinal herniorrhaphy in male infertility patients.
abstract: OBJECTIVE
  To study the incidence, diagnosis, and treatment of unilateral obstruction of the vas deferens caused by inguinal herniorrhaphy (IH) during childhood.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Kyoto University Hospital.
  
  
  METHODS
  Unilateral obstruction of the vas deferens after IH was diagnosed and treated in 10 of 724 subfertile patients.
  
  
  METHODS
  Reanastomosis of the vas deferens using a microsurgical two-layer technique.
  
  
  METHODS
  Follow-up seminal analysis of the patients and the occurrence of pregnancy in their wives.
  
  
  RESULTS
  The incidence of unilateral vas deferens obstruction caused by IH was 26.7% for subfertile patients with a history of IH during childhood. Unilateral vas deferens obstruction was detected through palpation of the scrotal vas deferens in 7 of the 10 patients. After vasovasostomy, the semen quality improved in 5 patients, and pregnancy was achieved by 2 patients.
  
  
  CONCLUSIONS
  The incidence of vas deferens obstruction was unexpectedly high in subfertile patients with a history of IH during childhood. Careful palpation of the scrotal content was a useful and noninvasive method to diagnose unilateral vas deferens obstruction, and microsurgical vasovasostomy was treatment of choice.
authors.affiliation: Department of Urology, Kyoto University Hospital, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Matsuda
authors.forename: Y
authors.initials: Y
authors.lastname: Horii
authors.forename: O
authors.initials: O
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D005260:Female; D005832:Genital Diseases, Male / Q000209:etiology* / Q000601:surgery; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000601:surgery; D008297:Male; D008866:Microsurgery; D011183:Postoperative Complications; D011247:Pregnancy; D014649:Vas Deferens / Q000601:surgery*