Results of microsurgical anastomosis in men with seminal tract obstruction due to inguinal herniorrhaphy
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
;
58(6): 305-309, 2003. tab
Artigo
em Inglês
| LILACS
| ID: lil-354163
ABSTRACT
The incidence of vasal injury during inguinal herniorrhaphy is estimated at 0.5 percent. We sought to assess the patency rates and long-term fertility outcome after microsurgical repair of vasal obstruction related to prior inguinal herniorrhaphy. METHODS:
Twenty procedures were performed on 13 men diagnosed with infertility and vasal injury secondary to previous inguinal herniorrhaphy. Eight of these men had undergone bilateral and 5 unilateral inguinal herniorrhaphy. Twelve procedures were vasovasostomies, 3 were crossover vasovasostomies, 2 were vasoepididymostomies, and 3 were crossover vasoepididymostomies. Eight patients were azoospermic, 2 were severely oligospermic (<1 M/mL), 1 was oligospermic, and 2 were asthenospermic. Patency data was obtained on all 13 patients, and pregnancy data was available for 10 couples (77 percent), with a mean follow-up of 69.5 months.RESULTS:
The overall patency rate was 65 percent. In the vasovasostomy group, the patency rate was 60 percent (9/15), and in the vasoepididymostomy group it was 80 percent (4/5). Among the azoospermic patients, 13 procedures were performed. The patency rate was 42.9 percent for the vasovasostomy (3/7), and 100 percent for the vasoepididymostomy procedure (4/4). The overall pregnancy rate was 40 percent. Of the men who underwent vasoepididymostomy, 80 percent (4/5) established a pregnancy.CONCLUSIONS:
Microsurgical vasovasostomy after inguinal vas injury results in a reasonable patency rate but a lower pregnancy rate than that after vasectomy reversal. When microsurgical vasoepididymostomy was possible, it resulted in high patency and pregnancy rate. Crossover vasoepididymostomy, when appropriate, can be a useful alternative to inguinal vasovasostomy
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Herniorrafia
/
Microcirurgia
Limite:
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
Assunto da revista:
Medicina
Ano de publicação:
2003
Tipo de documento:
Artigo
País de afiliação:
Estados Unidos
Instituição/País de afiliação:
Center for Advanced Research in Human Reproduction and Infertility/US
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