Scrotal exploration in 123 azoospermic patients: the results of survey for obstructive azoospermia

During the last eight years, scrotal exploration for attempted vasoepididymostomy was performed in 123 azoospermic patients at the King Faisal Specialist Hospital and Research Centre. All patients had normal or slightly elevated serum FSH, and normal-size testes [at least on one side]. Testicular biopsy was not recommended but had already been done before referral in 73 patients and was reported to show normal spermatogenesis or mild hypospermatogenesis. Vasoepididymostomy could be performed in only 83 [67.5%] patients using the conventional fistula technique in 34 patients and microsurgical single tubule anastomosis in 49 patients. Sixty-seven patients were followed between six and 30 months [mean 17.8 months]. Among these patients, 25 produced sperm in the ejaculate with a patency rate of 37.3 percent and seven patients impregnated their wives, for a pregnancy rate of 10.4%. These pregnancies resulted in four living children. The patency rate with the conventional fistula technique was [7/26] 26.9%, and with microsurgical technique [18/41] 43.9%; the difference is statistically significant. Microsurgical single tubule vasoepididymostomy is strongly recommended for the treatment of obstructive azoospermic patients, as it gives a higher percentage of successful anastomosis

Permanent urethral stents for the treatment of recurrent urethral strictures

A total of seven patients with recurrent anterior urethral strictures were treated by endoscopic implantation of end urethral wallstent prosthesis. The stent is a selfexpanding stainless steel tubular mesh which, when implanted in the urethra, creates an open lumen by pressing against the urethral wall. Patients ages ranged from 28 to 67 years [mean age 47.1 years]. The follow-up period ranged from six to fifteen months [mean nine months]. Peak flow rate improved from 7.5 +/- 2 ml/sec [mean +/- S.D.] preoperatively to 22.6 +/- 6.7 ml/sec [mean +/- S.D.] six months after the procedure. Urethroscopy demonstrated complete epithelial covering of the stent within 6 months. The technique is simple and offers an effective and attractive form of treatment for selected urethral strictures. A longer follow-up is necessary