Relationship of gross appearance of vas fluid during vasovasostomy to sperm quality, obstructive interval and sperm granuloma.

To study its intraoperative significance the gross appearance of the vas fluid found during vasovasostomy was compared to the quality of sperm in the fluid, obstructive interval and presence or absence of a histologically proved sperm granuloma. Data were obtained from 648 vasa in 340 patients. As the gross appearance increased in opacity, there was a small decrease in the proportion of morphologically normal, motile sperm (23 to 7 per cent) and a corresponding small increase in the proportion of sperm without tails (2 to 12 per cent). These minor trends had statistical but no intraoperative surgical significance. There was no variation in the proportion of vas fluid azoospermia with gross appearance. There was no significant difference in the gross appearance of the vas fluid with increasing obstructive interval. Finally, the presence or absence of a sperm granuloma had no effect on the gross appearance of the vas fluid, and the appearance had no predictive value relative to sperm granuloma. We conclude that the gross appearance of the vas fluid should not be used as a basis for operative decision-making during vasovasostomy.