Androlog Mail
My patient is a 32 year old male referred for azoospermia. He had bilateral
inguinal hernia repairs as an infant. Both testes are normal size, and all
hormone levels are normal. There is bilateral epididymal dilation and
induration. He and his wife don't want sperm aspiration/ICSI. Testis
biopsies showed mature sperm bilaterally, consistent with obstruction.
I believe he likely has bilateral inguinal obstruction from the hernia
repairs, with possible secondary epididymal obstruction. I plan to perform
vasograms, and if possible inguinal vasovasostomies. If the vasal fluid has
no sperm, he will also need epididymovasostomies. All the literature I've
seen recommends staged repairs, with inguinal repair first, and EV after 6-12
months if patient remains azoospermic (clearly he will if there is epididymal
obstruction).
My question is: Has anyone performed simultaneous ipsilateral inguinal VV and
scrotal EV ? If so, what was the outcome? Any other thoughts or
suggestions? Thanks for your help.
Mark L. Fallick, MD
Center for Urologic Care
Voorhees, NJ 08043
mfallick@cucnj.com
856-751-7772
This archive was generated by hypermail 2.1.2 : Mon Jun 11 2001 - 22:45:23 CDT