title: Contemporary outcomes of seminal tract re-anastomoses for obstructive azoospermia: a nationwide Japanese survey.
abstract: OBJECTIVE
  To evaluate current outcomes of seminal tract re-anastomoses in Japan, and to compare them with historical data.
  
  
  METHODS
  A total of 213 patients with obstructive azoospermia who underwent seminal tract re-anastomosis from April 2008 to March 2012 at 25 institutions were enrolled in the present study. The outcomes of the procedure were compared with those reported in a previous multi-institutional study carried out in 2000.
  
  
  RESULTS
  The percentage of partners aged over 35 years was 37%. A microsurgical double-layer anastomosis was carried out 83.0% of the time. Sperm were observed in ejaculate postoperatively in 68.9% and 41.5% of patients who underwent a vasovasostomy or a vasoepididymostomy, respectively. Natural conception occurred in 27.5% of patients after a vasectomy and 32.3% of patients with an epididymal obstruction. Except for the ratio of natural conception in patients with vasal obstruction after herniorrhaphies, there were no significant differences in final ratios of sperm appearance and natural conception between the previously reported study and the present study.
  
  
  CONCLUSIONS
  Compared with historical data, contemporary seminal tract re-anastomosis in Japan seems to provide equivalent or better outcomes, depending on the cause of obstruction. Seminal tract re-anastomosis is a valid treatment option for patients with obstructive azoospermia.
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Osaka, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Teruaki
authors.initials: T
authors.lastname: Iwamoto
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nagai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okada
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujimura
authors.forename: Koji
authors.initials: K
authors.lastname: Shiraishi
authors.forename: Hatsuki
authors.initials: H
authors.lastname: Hibi
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagao
authors.forename: Akira
authors.initials: A
authors.lastname: Iwasaki
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kamba
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tomomasa
authors.forename: Shingo
authors.initials: S
authors.lastname: Takada
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D053713:Azoospermia / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000473:pathology / Q000601:surgery; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D012669:Seminal Vesicles / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
keywords: male infertility; obstructive azoospermia; seminal tract re-anastomosis; vasoepididymostomy; vasovasostomy