title: Obstructive azoospermia as an unusual complication associated with herniorrhaphy of an omphalocele: a case report.
abstract: BACKGROUND
  Iatrogenic damage to the seminal tract is one of the causes of obstructive azoospermia, which can be an indication for reconstruction surgery. We present a case of obstructive azoospermia as an unusual complication after neonatal herniorrhaphy of an omphalocele.
  
  
  METHODS
  A 30-year-old Japanese man was diagnosed with obstructive azoospermia. He had undergone herniorrhaphy of an omphalocele immediately after birth. Reconstruction surgery of both seminal tracts was performed to pursue the possibility of naturally achieved pregnancy. Intra-operative findings demonstrated that both vasa deferentia were interrupted at the internal inguinal rings, although the abdominal end of the right vas leading to the seminal vesicle was found in the abdominal cavity. The discharge from the stump of the testicular end had no sperm, although the right epididymal tubules were dilated with motile sperm. Therefore, we performed right-sided vasovasostomy in the internal inguinal ring and ipsilateral epididymovasostomy simultaneously.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first report describing obstructive azoospermia as an unusual complication of herniorrhaphy of an omphalocele. It is important to pay attention to the existence of seminal tracts in such surgery as well as in inguinal herniorrhaphy.
authors.affiliation: Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan. nishiuro@kuhp.kyoto-u.ac.jp.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tsuchihashi
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Okubo
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ichioka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soda
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kanematsu
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama