Laparoscopic retrieval of retroperitoneal vas deferens in vasovasostomy for postinguinal herniorrhaphy obstructive azoospermia.
OBJECTIVE
Iatrogenic injury to the vas deferens is a well-documented complication of inguinal hernia repair. Recently obstruction related to the use of polypropylene mesh for hernia repair has been reported. We describe a case using laparoscopy to mobilize the retroperitoneal vas and deliver it to the healthy vas proximal to the vas trapped in the cicatrix induced by mesh thus allowing a tension-free microsurgical repair.


METHODS
Case report.


METHODS
Outpatient male infertility practice.


METHODS
Obstructed azoospermic men with polypropylene mesh.


METHODS
Laparoscopic retrieval of retroperitoneal vas segment for primary microsurgical anastomosis.


METHODS
Patency of vas and presence of sperm.


RESULTS
A tension-free, patent anastomosis was performed.


CONCLUSIONS
Polypropylene mesh-induced fibrosis of the vas deferens can result in obstructive azospermia. Laparoscopy can be used to permit a microsurgical bypass of the obstructed segment.
Nagler
Harris M
HM
Department of Urology, Beth Israel Medical Center, New York, New York, USA.
Belletete
Beth A
BA
Gerber
Eric
E
Dinlenc
Caner Z
CZ
D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007248:Infertility, Male / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009845:Oligospermia / Q000601:surgery*; D012187:Retroperitoneal Space; D014649:Vas Deferens / Q000601:surgery*; D014669:Vasovasostomy / Q000009:adverse effects* / Q000379:methods