Rapidly progressing, late-onset obstructive azoospermia linked to herniorrhaphy with mesh.

OBJECTIVE: To report a case of a man presenting with rapidly progressing inguinal vasal obstruction 5 years after bilateral herniorrhaphy with polypropylene mesh.
DESIGN: Case report with a review of the scientific literature.
SETTING: Male infertility clinic, Kobe University Hospital (Kobe, Japan). PATIENT(S): A 30-year-old patient who had undergone bilateral inguinal herniorrhaphy using polypropylene mesh 5 years previously. INTERVENTION(S): The patient underwent bilateral vasography and left testicular sperm extraction (TESE). MAIN OUTCOME MEASURE(S): Long-term effects of the adult inguinal herniorrhaphy with polypropylene mesh. RESULT(S): Rapid progression of vas deferens obstruction occurred within several months. We performed left TESE for intracytoplasmic sperm injection (ICSI) and retrieved many motile sperm. CONCLUSION(S): Before azoospermia, men who undergo inguinal herniorrhaphy using polypropylene mesh need to rapidly cryopreserve their sperm for future fertility; TESE-ICSI is also a selectable treatment.