Early patency rates after the two-suture invagination technique of vaso-epididymal anastomosis for idiopathic obstruction.
OBJECTIVE
To prospectively evaluate the results of vaso-epididymostomy, using a two-suture microsurgical invagination technique, when used for men with azoospermia due to an obstruction at the vaso-epididymal junction.


METHODS
Between December 2002 and November 2004, 29 men with idiopathic obstructive azoospermia underwent vaso-epididymostomy with the two-suture invagination technique. The patency rate was assessed by return of sperm in the semen after surgery.


RESULTS
In all, 23 men provided at least one postoperative semen sample. The mean (range) follow-up was 7.6 (1.5-30) months. In 11 of these men (48%), patency was shown at a mean of 3.2 (1.5-7) months after surgery. The median sperm density was 17 (10-65) million/mL. Four men had normal sperm density and motility (>20 million/mL; >50% total motility).


CONCLUSIONS
Men with idiopathic vaso-epididymal junction obstruction can have significant sperm positivity after vaso-epididymostomy. With a patency rate of nearly half within a year of surgery, vaso-epididymostomy should be the first line of therapy for these men.
Department of Urology, All India Institute of Medical Sciences, New Delhi, India. rajeev02@gmail.com
Rajeev
R
Kumar
Gagan
G
Gautam
Narmada P
NP
Gupta
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D004822:Epididymis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D009845:Oligospermia / Q000601:surgery*; D011446:Prospective Studies; D012661:Semen / Q000737:chemistry; D013076:Sperm Count; D013081:Sperm Motility; D013536:Suture Techniques; D016896:Treatment Outcome; D014649:Vas Deferens / Q000601:surgery*