Tsuchihashi Kazunari, Okubo Kazutoshi, Ichioka Kentaro, Soda Takeshi, Yoshimura Koji, Kanematsu Akihiro, Ogawa Osamu, Nishiyama Hiroyuki
Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
J Med Case Rep. 2011 Jun 25;5:234. doi: 10.1186/1752-1947-5-234.
Iatrogenic damage to the seminal tract is one of the causes of obstructive azoospermia, which can be an indication for reconstruction surgery. We present a case of obstructive azoospermia as an unusual complication after neonatal herniorrhaphy of an omphalocele.
A 30-year-old Japanese man was diagnosed with obstructive azoospermia. He had undergone herniorrhaphy of an omphalocele immediately after birth. Reconstruction surgery of both seminal tracts was performed to pursue the possibility of naturally achieved pregnancy. Intra-operative findings demonstrated that both vasa deferentia were interrupted at the internal inguinal rings, although the abdominal end of the right vas leading to the seminal vesicle was found in the abdominal cavity. The discharge from the stump of the testicular end had no sperm, although the right epididymal tubules were dilated with motile sperm. Therefore, we performed right-sided vasovasostomy in the internal inguinal ring and ipsilateral epididymovasostomy simultaneously.
To the best of our knowledge, this is the first report describing obstructive azoospermia as an unusual complication of herniorrhaphy of an omphalocele. It is important to pay attention to the existence of seminal tracts in such surgery as well as in inguinal herniorrhaphy.
医源性生殖道损伤是梗阻性无精子症的病因之一，可作为重建手术的指征。我们报告一例梗阻性无精子症，这是脐膨出新生儿疝修补术后一种罕见的并发症。
一名30岁的日本男性被诊断为梗阻性无精子症。他出生后立即接受了脐膨出疝修补术。为了寻求自然受孕的可能性，对双侧生殖道进行了重建手术。术中发现双侧输精管在腹股沟内环处中断，尽管在腹腔内发现了通向精囊的右侧输精管的腹腔端。睾丸端残端的排出物中没有精子，尽管右侧附睾管扩张且有活动精子。因此，我们同时在腹股沟内环处进行了右侧输精管吻合术和同侧附睾输精管吻合术。
据我们所知，这是第一例将梗阻性无精子症描述为脐膨出疝修补术罕见并发症的报告。在这类手术以及腹股沟疝修补术中，关注生殖道的存在非常重要。
