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

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.