title: [Surgical treatment of obstructive azoospermia: a report of 56 cases].
abstract: OBJECTIVE
  To evaluate the diagnosis and surgical treatment of obstructive azoospermia.
  
  
  METHODS
  We analyzed the clinical data of 56 cases of obstructive azoospermia, 43 of them with ejaculatory duct obstruction (EDO), and the other 13 suspected of epididymal obstruction. The diagnostic methods included semen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, transrectal ultrasonography (TRUS), and vasography when necessary. The 43 patients with EDO were treated by transurethral resection of the ejaculatory duct (TURED), and 11 of the 13 cases of suspected epididymal obstruction were confirmed by scrotal exploration and underwent either bilateral or unilateral vasoepididymostomy. The patients were followed up for 3 -51 months for postoperative semen quality and impregnation.
  
  
  RESULTS
  Of the 43 azoospermia patients with EDO treated by TURED, 36 (83.7%) showed improved semen parameters and 11 (25.6%) achieved pregnancies. Among the 11 cases of azoospermia with confirmed epididymal obstruction treated by vasoepididymostomy, 6 (54.5%) had sperm in the semen assay and 3 (27.3%) achieved pregnancies.
  
  
  CONCLUSIONS
  Semen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, TRUS and vasography are important diagnostic methods for obstructive azoospermia. TURED is effective for azoospermia with EDO, while vasoepididymostomy is preferable for the treatment of azoospermia with epididymal obstruction.
authors.affiliation: Department of Urology, Huangpu Branch of the First Hospital Affiliated to Sun Yat-sen University, Guangzhou, Guangdong 510700, China.
authors.forename: Xiang-An
authors.initials: XA
authors.lastname: Tu
authors.forename: Liang-Yun
authors.initials: LY
authors.lastname: Zhao
authors.forename: Li-Wen
authors.initials: LW
authors.lastname: Deng
authors.forename: Wen-Wei
authors.initials: WW
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Zhao
authors.forename: Hui
authors.initials: H
authors.lastname: Liang
authors.forename: Ling-You
authors.initials: LY
authors.lastname: Zeng
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Deng
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000209:etiology / Q000601:surgery*; D004822:Epididymis / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D011859:Radiography; D012007:Rectum / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014463:Ultrasonography; D014649:Vas Deferens / Q000000981:diagnostic imaging / Q000601:surgery