Prognostic factors in the surgical treatment of azoospermia.
Surgery for male obstructive infertility is not always successful. A number of clinical and operative findings, not previously reported, may influence the outcome. We have studied 182 patients with azoospermia who underwent vasoepididymostomy. The pre-operative and operative findings which adversely affected the function of the anastomosis were identified. The presence of spermatozoa in the semen sample was taken to mean a successful anastomosis. Abnormal testicular histology was an adverse pre-operative finding. Adverse operative findings included non-canalisation of the epididymal tubules and hypoplasia of the epididymis; both factors were associated with a high failure rate (almost 100%). The anastomosis was a failure in 78% of the patients when no fluid was seen on sectioning the epididymis. In the absence of adverse findings the success rate of vasoepididymostomy was 59%. Pre-operative testicular biopsy, together with careful observation and recording of findings before and during surgery, are recommended to avoid needless exploration and anastomosis.
Kapur
M M
MM
Department of Surgery, All India Institute of Medical Sciences, New Delhi.
Sood
S
S
Kochar
K P
KP
Paul
S
S
Rao
S V
SV
D000328:Adult; D000714:Anastomosis, Surgical; D004822:Epididymis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D013076:Sperm Count; D013737:Testis / Q000473:pathology; D014649:Vas Deferens / Q000601:surgery*