J Korean Androl Soc.  1997 Dec;15(2):165-169.

Transseptal Microscopic Epididymovasostomy in Patient with Unilateral Vasal Agenesis and Contralateral Testicular Atrophy

• Paick JS
• Lim D

Abstract

Unilateral or bilateral congenital absence of the vas deferens is uncommon but not rare, being found in 1.4% of infertile men. The use of alloplastic spermatoceles to recover sperm for insemination has provided poor results. Now, therapy has been directed at microsurgical aspiration of sperm from the epididymis for use in intracytoplasmic sperm injection (ICSI).Recently, we performed transseptal microscopicsingle0tubular epididymovasostomy in a patient with unilateral vasal agenesis and contralateral testicular atrophy. The epididymis was mobilized from the testis, and the epididymal tubule was dissected from the tunics sufficiently to achieve a tension-free anastomosis. The patient is now expected to have normal fertility. Even in era of ICSI, microsurgery which allows natural pregnancies should be sought frist as a treatment option in obstructive azoospermia.

MeSH Terms

Atrophy*
Azoospermia
Epididymis
Fertility
Humans
Infertility, Male
Insemination
Male
Microsurgery
Pregnancy
Sperm Injections, Intracytoplasmic
Spermatocele
Spermatozoa
Testis
Vas Deferens
Vasovasostomy