Surgical treatment of obstructive azoospermia

The records of 325 azoospermic patients were reviewed. A total of 109 patients (33.5%) had obstructive azoospermia and 48 of them underwent surgical treatment. Three patients had vas deferens agenesia and underwent artificial spermatocele; 14 with epididymal obstruction were treated by an end-to-end microsurgical vasoepididymostomy; and 31 vasectomized patients were submitted to microsurgical reversal. There was no pregnancy in the spermatocele patients. In the vasoepididymostomy patients 60% became patent and 30% achieved pregnancy. In the reversal group 90% of patency and pregnancy rate of 80% were observed, in a mean follow-up of 21 months. The last 8 cases were treated with a biological glue and 7 showed patency and one pregnancy in a 3-month follow-up period. One was lost to follow-up.