Repeat epididymovasostomies: are they worthwhile?

Objective To establish whether it is worthwhile repeating epididymovasostomy in men with persistent obstructive azoospermia. Patients and methods The study included 24 men with obstructive azoospermia, persisting after previous surgery for blockage in the body or tail of the epididymes, who underwen...

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Bibliographic Details
Published in:BJU international 1999-05, Vol.83 (7), p.816-819
Main Authors: Nigam, A K, Hendry, W F
Format: Article
Language:English
Subjects:
Anastomosis, Surgical - methods
Azoospermia
caudal blocks
Female
Humans
Male
Oligospermia - surgery
Pregnancy - statistics & numerical data
Reoperation
repeat epididymovasostomy
Retrospective Studies
Sperm Count
Urogenital Surgical Procedures - methods
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Summary:Objective To establish whether it is worthwhile repeating epididymovasostomy in men with persistent obstructive azoospermia. Patients and methods The study included 24 men with obstructive azoospermia, persisting after previous surgery for blockage in the body or tail of the epididymes, who underwent repeat epididymovasostomy proximal to the previous anastomoses. Semen was re‐analysed after 6 and 12 months, and information about pregnancy self‐reported or determined by postal survey. Results The postoperative sperm concentration was >107 /mL in 15 patients (62%) and 10 female partners became pregnant (41%). Antisperm antibodies were present in nine patients and three of their partners became pregnant after the man received steroid therapy. Unilateral revision did not produce a favourable outcome. Conclusion Having defined a favourable group of men with obstructive azoospermia by scrotal exploration, i.e. those with caudal epididymal blocks and patent vasa deferentia, initial technical failure should not preclude surgical revision of the anastomoses in selected cases.
ISSN:1464-4096
1464-410X
DOI:10.1046/j.1464-410x.1999.00999.x