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  • Title: Unilateral obstruction of the vas deferens caused by childhood inguinal herniorrhaphy in male infertility patients.
    Author: Matsuda T, Horii Y, Yoshida O.
    Journal: Fertil Steril; 1992 Sep; 58(3):609-13. PubMed ID: 1521659.
    Abstract:
    OBJECTIVE: To study the incidence, diagnosis, and treatment of unilateral obstruction of the vas deferens caused by inguinal herniorrhaphy (IH) during childhood. DESIGN: Retrospective. SETTING: Kyoto University Hospital. PATIENTS: Unilateral obstruction of the vas deferens after IH was diagnosed and treated in 10 of 724 subfertile patients. INTERVENTIONS: Reanastomosis of the vas deferens using a microsurgical two-layer technique. MAIN OUTCOME MEASURES: Follow-up seminal analysis of the patients and the occurrence of pregnancy in their wives. RESULTS: The incidence of unilateral vas deferens obstruction caused by IH was 26.7% for subfertile patients with a history of IH during childhood. Unilateral vas deferens obstruction was detected through palpation of the scrotal vas deferens in 7 of the 10 patients. After vasovasostomy, the semen quality improved in 5 patients, and pregnancy was achieved by 2 patients. CONCLUSIONS: The incidence of vas deferens obstruction was unexpectedly high in subfertile patients with a history of IH during childhood. Careful palpation of the scrotal content was a useful and noninvasive method to diagnose unilateral vas deferens obstruction, and microsurgical vasovasostomy was treatment of choice.
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