Open AccessLaparoscopy‐assisted vasovasostomy for post‐herniorrhaphy vas deferens obstruction
Author(s) -
Uchida Masahiro,
Iida Shuichi,
Hoshi Kazuhiko,
Kojo Kosuke,
Tsuchiya Haruki,
Yamasaki Kazumitsu,
Miyazaki Jun,
Iwamoto Teruaki
Publication year - 2020
Publication title -
iju case reports
Language(s) - English
Resource type - Journals
ISSN - 2577-171X
DOI - 10.1002/iju5.12150
Subject(s) - vasovasostomy , intracytoplasmic sperm injection , medicine , azoospermia , vas deferens , obstructive azoospermia , testicular sperm extraction , sperm retrieval , semen analysis , laparoscopy , surgery , urology , gynecology , population , pregnancy , infertility , biology , family planning , environmental health , research methodology , genetics
Repair of obstructive azoospermia caused by childhood herniorrhaphy may be difficult. Therefore, intracytoplasmic sperm injection using testicular sperm is performed. However, vasovasostomy combined with laparoscopic surgery is challenging. Case presentation A 42‐year‐old man underwent inguinal hernia repair at age 3. He had normal testicular size, azoospermia, normal hormone levels (follicle‐stimulating hormone, luteinizing hormone, and testosterone), absence of Y chromosome micro deletion, and karyotype:46XY, t(1:21)(p34.1:q22.3). He was diagnosed with obstructive azoospermia. Repeated intracytoplasmic sperm injections using testicular sperm resulted in miscarriages. Vasovasostomy combined with laparoscopic surgery was subsequently performed. Postoperative semen analysis result was almost normal. After intracytoplasmic sperm injection of ejaculated sperm, his wife got pregnant. Conclusion Even if patients have chromosomal abnormalities, performing microsurgical re‐anastomosis first is recommended. To our knowledge, this is the first case of a laparoscopy‐assisted vasovasostomy for post‐herniorrhaphy vas deferens obstruction in Japan.