OBJECTIVES: To prospectively evaluate the results of vaso-epididymostomy, using a two-suture microsurgical invagination technique, when used for men with azoospermia due to an obstruction at the vaso-epididymal junction. PATIENTS AND METHODS: Between December 2002 and November 2004, 29 men with idiopathic obstructive azoospermia underwent vaso-epididymostomy with the two-suture invagination technique. The patency rate was assessed by return of sperm in the semen after surgery. RESULTS: In all, 23 men provided at least one postoperative semen sample. The mean (range) follow-up was 7.6 (1.5-30) months. In 11 of these men (48%), patency was shown at a mean of 3.2 (1.5-7) months after surgery. The median sperm density was 17 (10-65) million/mL. Four men had normal sperm density and motility (>20 million/mL; >50% total motility). CONCLUSIONS: Men with idiopathic vaso-epididymal junction obstruction can have significant sperm positivity after vaso-epididymostomy. With a patency rate of nearly half within a year of surgery, vaso-epididymostomy should be the first line of therapy for these men.
OBJECTIVES: To prospectively evaluate the results of vaso-epididymostomy, using a two-suture microsurgical invagination technique, when used for men with azoospermia due to an obstruction at the vaso-epididymal junction. PATIENTS AND METHODS: Between December 2002 and November 2004, 29 men with idiopathic obstructive azoospermia underwent vaso-epididymostomy with the two-suture invagination technique. The patency rate was assessed by return of sperm in the semen after surgery. RESULTS: In all, 23 men provided at least one postoperative semen sample. The mean (range) follow-up was 7.6 (1.5-30) months. In 11 of these men (48%), patency was shown at a mean of 3.2 (1.5-7) months after surgery. The median sperm density was 17 (10-65) million/mL. Four men had normal sperm density and motility (>20 million/mL; >50% total motility). CONCLUSIONS:Men with idiopathic vaso-epididymal junction obstruction can have significant sperm positivity after vaso-epididymostomy. With a patency rate of nearly half within a year of surgery, vaso-epididymostomy should be the first line of therapy for these men.