Unsatisfactory Results of Epididymovasostomy for Post-Inflammatory Obstruction

Abstract

A total of 147 patients were treated surgically for the correction of post-testicular azoospermias due to epididymal obstruction during the past 17 years. Thirty-eight patients were operated by the microsurgical technique and the remaining patients were operated by the conventional technique. The anatomical success rate was 29 %, and the functional success rate, 11% in the 130 patients who were followed-up for more than 1 year after the epididymovasostomy, The success rates were higher in patients with nontuberculous epididymitis than in patients with tuberculous epididymitis. No significant differences were found in both anatomical and functional success rates by the anastomosis levels of the epididymis. Our cbservation en failed epididymovasostcmy at recperaticn revealed that there were marked scar formation with sperm and suture granulomas and blockage of the opening of the original epididymal tubule at the site of the previous anastomosis. It is, therefore, ideal to attempt direct anastomosis between the original epididymal tubule and the mucosal layer of vas deferens.