Matsuda T, Horii Y, Yoshida O
Department of Urology, Kyoto University Hospital, Japan.
Fertil Steril. 1992 Sep;58(3):609-13. doi: 10.1016/s0015-0282(16)55272-8.
To study the incidence, diagnosis, and treatment of unilateral obstruction of the vas deferens caused by inguinal herniorrhaphy (IH) during childhood.
Retrospective.
Kyoto University Hospital.
Unilateral obstruction of the vas deferens after IH was diagnosed and treated in 10 of 724 subfertile patients.
Reanastomosis of the vas deferens using a microsurgical two-layer technique.
Follow-up seminal analysis of the patients and the occurrence of pregnancy in their wives.
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.
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.
研究儿童期腹股沟疝修补术（IH）所致单侧输精管梗阻的发生率、诊断及治疗。
回顾性研究。
京都大学医院。
724例不育患者中有10例在IH后被诊断并治疗为单侧输精管梗阻。
采用显微外科双层技术进行输精管再吻合术。
对患者进行随访精液分析及观察其妻子的妊娠情况。
有儿童期IH病史的不育患者中，IH所致单侧输精管梗阻的发生率为26.7%。10例患者中有7例通过触诊阴囊内输精管检测到单侧输精管梗阻。输精管吻合术后，5例患者精液质量改善，2例患者妻子受孕。
有儿童期IH病史的不育患者中，输精管梗阻的发生率出乎意料地高。仔细触诊阴囊内容物是诊断单侧输精管梗阻的一种有用且无创的方法，显微外科输精管吻合术是首选治疗方法。
