Unilateral obstruction of the vas deferens caused by childhood inguinal herniorrhaphy in male infertility patients

Abstract

Objective: To study the incidence, diagnosis, and treatment of unilateral obstruction of the vas deferens caused by inguinal herniorrhaphy (IH) during childhood.

Design: Retrospective.

Setting: Kyoto University Hospital.

Patients: Unilateral obstruction of the vas deferens after IH was diagnosed and treated in 10 of 724 subfertile patients.

Interventions: Reanastomosis of the vas deferens using a microsurgical two-layer technique.

Main outcome measures: Follow-up seminal analysis of the patients and the occurrence of pregnancy in their wives.

Results: The incidence of unilateral vas deferens obstruction caused by IH was 26.7% for subfertile patients with a history of IH during childhood. Unilateral vas deferens obstruction was detected through palpation of the scrotal vas deferens in 7 of the 10 patients. After vasovasostomy, the semen quality improved in 5 patients, and pregnancy was achieved by 2 patients.

Conclusions: The incidence of vas deferens obstruction was unexpectedly high in subfertile patients with a history of IH during childhood. Careful palpation of the scrotal content was a useful and noninvasive method to diagnose unilateral vas deferens obstruction, and microsurgical vasovasostomy was treatment of choice.