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Intravasal azoospermia: a surgical dilemma
Y R Sheynkin1, M E Chen, M Goldstein
1Center for Male Reproductive Medicine and Microsurgery, Department of Urology, New York Hospital-Cornell Medical Center, Population Council, Center for Biomedical Research, New York, NY 10021, USA.
BJU International
|June 10, 2000
Summary
Intravasal azoospermia (IVA) occurs in 5.7% of vasovasostomies (VV). Clear fluid in the vas deferens improves post-surgery sperm presence, but outcomes for IVA patients remain unsatisfactory.
Area of Science:
- Urology
- Reproductive Medicine
- Surgical Outcomes
Background:
- Intravasal azoospermia (IVA) is a condition where no sperm are found in the vas deferens during vasovasostomy (VV).
- The incidence and impact of IVA on VV success rates require further investigation.
Purpose of the Study:
- To determine the incidence of intravasal azoospermia (IVA).
- To evaluate pre-operative and intra-operative factors influencing VV outcomes in men with IVA.
Main Methods:
- Prospective study of 472 men undergoing microsurgical VV.
- Intravasal fluid was examined for sperm during surgery.
- Patients were followed up with semen analysis and paternity assessment.
Main Results:
- Bilateral IVA was identified in 27 patients (5.7%).
- Of 15 followed patients with IVA, 7 had sperm in ejaculate post-VV.
- A higher patency rate was observed in men with clear intravasal fluid.
Conclusions:
- Vasovasostomy outcomes in patients with IVA are generally unsatisfactory.
- The presence of clear fluid in the vas deferens may correlate with improved patency.
- Obstruction interval does not appear to significantly influence VV outcomes in IVA patients.