title: Sperm analysis of the vas deferens fluid after a long interval of unilateral percutaneous epididymal sperm aspiration in vasectomized patients.
abstract: OBJECTIVE
  Evaluation of the presence of spermatozoa in vas deferens fluid after a long interval of unilateral and homolateral percutaneous epididymal sperm aspiration (PESA) in vasectomized men. When found, the spermatozoa were evaluated including concentration and motility, in order to verify the patency of the epididymal tubules.
  
  
  METHODS
  Four patients, numbered in a progressive order, from one to four, with 38, 40, 48 and 51 years old and vasectomy interval of 10, 10, 25 and 11 years, respectively, whose wives did not get pregnant using intracytoplasmic sperm injection of sperm obtained by unilateral PESA and decided to try only natural conception, were submitted to intrasurgical sperm analysis of the vas deferens fluid (ISAVDF) during microsurgery for reconstruction of the seminal tract.
  
  
  RESULTS
  Time interval between PESA and ISAVDF was 13.75 ± 11.12 months (x ± s) varying from 3 to 29 months. Homolateral ISAVDF and PESA showed the presence of spermatozoa. Patients 1, 2 and 4 had a high concentration of 10 x 106, 64 x 106 and 45 x 106 spermatozoa/ mL; the first two had motile sperms and patient 3 had no sperms.
  
  
  CONCLUSIONS
  Three of four patients showed spermatozoa in the vas deferens fluid after a long interval of unilateral and homolateral PESA with high concentration, including motile forms. These findings support the concept that PESA may not result in late epipidymal tubule obstruction in vasectomized patients.
authors.affiliation: Department of Urology, Federal University of Parana and Department of Urology, Hospital Cruz Vermelha, Curitiba, Brazil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lorenzini
authors.forename: Eduardo
authors.initials: E
authors.lastname: Zanchet
authors.forename: Mariana
authors.initials: M
authors.lastname: Lorenzini
mesh_terms: D000328:Adult; D053713:Azoospermia; D004822:Epididymis / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D015203:Reproducibility of Results; D013076:Sperm Count; D013081:Sperm Motility; D053625:Sperm Retrieval; D013094:Spermatozoa; D013997:Time Factors; D016896:Treatment Outcome; D014649:Vas Deferens / Q000601:surgery*; D014659:Vasectomy; D014669:Vasovasostomy / Q000379:methods*