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Related Experiment Videos

Repeat epididymovasostomies: are they worthwhile?

A K Nigam1, W F Hendry

  • 1Department of Urology, St Bartholomew's Hospital, West Smithfield, London, UK.

BJU International
|June 15, 1999
PubMed
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Repeat epididymovasostomy can be successful for men with persistent obstructive azoospermia. This surgical revision led to improved sperm counts and pregnancies in a significant portion of selected patients.

Area of Science:

  • Urology
  • Reproductive Medicine
  • Surgical Innovation

Background:

  • Persistent obstructive azoospermia can occur after initial surgical interventions.
  • Epididymovasostomy is a surgical procedure to restore patency in the male reproductive tract.

Purpose of the Study:

  • To evaluate the efficacy of repeat epididymovasostomy in men with persistent obstructive azoospermia.
  • To identify factors predicting successful outcomes in revision surgeries.

Main Methods:

  • A cohort of 24 men with obstructive azoospermia underwent repeat epididymovasostomy.
  • Semen analysis was performed at 6 and 12 months post-surgery.
  • Pregnancy outcomes were monitored through self-reporting and postal surveys.

Main Results:

Related Experiment Videos

  • Postoperative sperm concentration exceeded 107/mL in 62% of patients.
  • 10 female partners (41%) achieved pregnancy.
  • Steroid therapy in patients with antisperm antibodies resulted in three pregnancies.

Conclusions:

  • Repeat epididymovasostomy is a viable option for selected men with obstructive azoospermia, particularly those with caudal epididymal blocks and patent vasa deferentia.
  • Initial surgical failure should not deter revision in carefully selected cases.
  • Successful outcomes can be achieved even after prior technical failures.