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.
Department of Surgery, All India Institute of Medical Sciences, New Delhi.
M M
MM
Kapur
S
S
Sood
K P
KP
Kochar
S
S
Paul
S V
SV
Rao
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*