Microsurgical epididymovasostomy for obstructive azoospermia: factors affecting postoperative fertility

Azoospermia due to epididymal obstruction can be treated by microsurgical epididymovasostomy with high patency rates. Twenty-four azoospermic patients with epididymal obstruction due to a variety of causes underwent 26 microsurgical epididymovasostomies. The overall patency rate following surgery was 80.8% and impregnation was achieved by 10 patients (41.7%). Factors affecting the postoperative impregnation rate were etiology and duration of obstruction. Patients with an obstruction for < or = 15 years, caused by epididymitis or post-vasectomy epididymal blow-out, achieved a higher impregnation rate than the others (8 of 9 vs. 2 of 11, p = 0.0019). The motility of epididymal sperm or the presence of serum antisperm antibodies had no apparent effect on postoperative fertility. Microsurgical epididymovasostomy is particularly effective in patients with epididymitis or vasectomy patients with a short-term obstruction.