Abstract
This chapter opens with a description of the anatomy and physiology of the male genital tract, and this is followed by a review of the pathological conditions that produce obstruction in particular sites. Preoperative clinical and laboratory assessment are next, matters of key importance if the surgeon is to recognise and interpret accurately the findings made at surgery. Operative approaches and technical details of reconstructive methods are described, fundamental for successful results. Long-term follow-up is essential if accurate audit is to be maintained, to allow the surgeon to compare his results with those reported by others; and finally failure — when should the surgeon give up, and when should he or she reoperate, to try again to make the perfect anastomosis and have it stay patent?
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Bandhauer K (1966) Immunoreaktionen bei fertilitatsstorungen des mannes. Urol Int 21:247–282
Brindley GS, Scott GI, Hendry WF (1986) Vas cannulation with implanted sperm reservoirs for obstructed azoospermia or ejaculatory failure. Br J Urol 58:721–723
Brown PC, Glynn LE (1969) The early lesion of experimental allergic orchitis in guinea pigs: an immunological correlation. J Pathol 98:277–282
Clarke GN, Elliott, PJ, Smaila C (1985) Detection of sperm antibodies in semen using the immunobead test: a survey of 813 consecutive patients. Am J Reprod Immunol 7:118–123
Clements FW (1960) The rise and decline of pink disease. Med J Aust 1:922–925
Colpi GM, Casella F, Zanollo A, Ballerini G, Balerna M, Campana A, Lange A (1987) Functional voiding disturbances of the ampullo-vesicular seminal tract: a cause of male infertility. Acta Eur Fertil 18:165–179
Dathan JG, Harvey CC (1965) Pink disease — ten years after (the epilogue). Br Med J i: 1181–1182
Dubin L, Amelar RD (1984) Magnified surgery for epididymo-vasostomy. Urology 23:525–528
Dumur V, Gervais R, Rigot JM et al. (1990) Abnormal distribution of CF F 508 allele in azoospermic men with congenital aplasia of epididymis and vas deferens. Lancet 336:512.
Fogdestam I, Fall M, Nilsson S (1986) Microsurgical epididymo-vasostomy in the treatment of occlusive azoospermia. Fertil Steril 46: 925–929
Friberg J (1974) A simple and sensitive micro-method for demonstration of sperm agglutinating antibodies in serum from infertile men and women. Acta Obstet Gynecol Scand (Suppl) 36:21–29
Gill B, Kogan S, Starr S, Reda E, Levitt S (1989) Significance of epididymal and ductal anomalies associated with testicular maldescent. J Urol 142:556–558
Greenstone MA, Rutman A, Hendry WF, Cole PJ (1988) Ciliary function in Young’s syndrome. Thorax 43:153–154
Hagner FR (1931) Sterility in the male. Surg Gynecol Obstet 52:330–335
Hagner FR (1936) The operative treatment of sterility in the male. J Am Med Assoc 107:1851–1854
Handelsman DJ, Conway AJ, Boylan LM, Turtle JR (1984) Young’s syndrome: obstructive azoospermia and chronic sinopulmonary infection. N Engl J Med 310:3–9
Harrison RG (1966) The anatomy of varicocele. Proc R Soc Med 59:763–765
Hendry WF (1986) Clinical significance of unilateral testicular obstruction in subfertile males. Br J Urol 58:709–714
Hendry WF, Pryor JP (1992) Mullerian duct (prostatic utricle) cyst: Diagnosis and treatment in subfertile males. Br J Urol 69:79–82
Hendry WF, Knight RK, Whitfield HN et al. (1978) Obstructive azoospermia: respiratory function tests, electron microscopy and the results of surgery. Br J Urol 50:598–604
Hendry WF, Stedronska J, Hughes L, Cameron KM, Pugh RCB (1979) Steroid treatment of male subfertility caused by antisperm antibodies. Lancet ii: 498–500
Hendry WF, Parslow JM, Stedronska J, Wallace DMA (1982) The diagnosis of unilateral testicular obstruction in subfertile males. Br J Urol 54:774–779
Hendry WF, Levison D, Parkinson CM, Parslow JM, Royle MR (1990) Testicular obstruction: clinico-pathological studies. Ann R Coll Surg Engl 72:396–407
Hendry WF, A’hern RP, Cole PJ (1993) Was Young’s syndrome caused by exposure to mercury in childhood? Br Med J 307:1579–1582
Hendry WF, Parslow JM, Parkinson MC, Lowe DG (1994) Unilateral testicular obstruction: orchidectomy or reconstruction. Hum Reprod (in press)
Hughes TM, Skolnick JL, Belker AM (1987) Young’s syndrome: an often unrecognised correctable cause of obstructive azoospermia. J Urol 137:1238–1240
Isojima S, Li TS, Ashitaka Y (1968) Immunologic analysis of sperm immobilizing factor found in sera of women with unexplained sterility. Am J Obstet Gynecol 101:677–683
Jequier AM (1985) Obstructive azoospermia: a study of 102 patients. Clin Reprod Fertil 3:21–36
Johnsen SG (1970) Testicular biopsy score count. A method for registration of spermatogenesis in human testis: normal values and results in 335 hypogonadal males. Hormones 1:1–24
Lee HY (1987) A 20-year experience with epididymo-vasostomy for pathological epididymal obstruction. Fertil Steril 47:487–491
Lespinasse VD (1918) Obstructive sterility in the male. Treatment by direct vaso-epididymostomy. J Am Med Assoc 70:448–450
Littrup PJ, Lee F, McLeary RD, Wu D, Lee A, Kumasaka GH (1988) Transrectal US of the seminal vesicles and ejaculatory ducts: clinical correlation. Radiology 168:625–628
Lunenfeld B, Mor A, Mani M (1967) Treatment of male infertility. I. Human gonadotrophins. Fertil Steril 1:581–592
Martin E, Carnett JB, Levi JV, Pennington ME (1902) The surgical treatment of sterility due to obstruction at the epididymis, together with a study of the morphology of human spermatozoa. Univ Penn Med Bull 15:2–15
Meinertz H, Linnet L, Anderrsen PF, Hjort T (1990) Antisperm antibodies and fertility after vasovasostomy: a follow-up study of 216 men. Fertil Steril 54:315–321
Maddocks S, Hargreave TB, Reddie K, Fraser HM, Kerr JB, Sharpe RM (1990) The role of secretion of inhibition and testosterone from the rat, guinea pig, macaque and human testis. In: Programme and abstracts of 6th European workshop on molecular and cellular endocrinology of the testis, Abstract D3. University of Turku, Finland
Michelson L (1949) Congenital abnormalities of the ductus deferens and epididymis. J Urol 61: 384–390
Mitchinson MJ, Sherman KP, Stainer-Smith AM (1975) Brown patches in the epididymis. J Pathol 115:57–62
Middleton RG, Smith JA, Moore MH, Urry RL (1987) A 15-year follow-up of a non-microsurgical technique for vasovasostomy. J Urol 137:886–887
Neville E, Brewis R, Yeates WK, Burridge A (1983) Respiratory tract disease and obstructive azoospermia. Thorax 38:929–933
Parkhouse H, Hendry WF (1991) Vasal injuries during childhood and their effect on subsequent fertility. Br J Urol 67:91–95
Parslow JM, Royle MG, Kingscott MMB, Wallace DMA, Hendry WF (1983) The effects of sperm antibodies on fertility after vasectomy reversal. Am J Reprod Immunol 3:28–31
Parslow JM, Poulton TA, Besser GM, Hendry WF (1985) The clinical relevance of classes of immunoglobulins on spermatozoa from infertile and vasovasostomised males. Fertil Steril 43: 621–627
Pavia D, Agnew JE, Bateman JRM, Sheahan NF, Knight RK, Hendry WF, Clarke SW (1981) Lung mucociliary clearance in patients with Young’s syndrome. Chest; 80 (suppl):892–895
Pryor JP, Hendry WF (1991) Ejaculatory duct obstruction in subfertile males: analysis of 87 patients. Fertil Steril 56:725–730
Pryor JP, Pugh RCB, Cameron KM Newton JR, Collins WP (1976) Plasma gonadotrophic hormones, testicular biopsy and seminal analysis in men of infertile marriages. Br J Urol 48:709–717
Royle MG, Hendry WF (1985) Why does vasectomy reversal fail? Br J Urol 57:780–783
Schoysman R (1982) Epididymal causes of male infertility: pathogenesis and management. In: White R de V (ed). Aspects of male infertility. Williams and Wilkins, Baltimore, pp 233–249
Schoysman RJ, Bedford JM (1986) The role of the human epididymis in sperm maturation and sperm storage as reflected in the consequences of epididymo-vasostomy. Fertil Steril 46:293–299
Shahmanesh M, Stedronska J, Hendry WF (1986) Antispermatozoal antibodies in men with urethritis. Fertil Steril 46:308–311
Silber SJ (1978) Vasectomy and vasectomy reversal. Fertil Steril 29:125–140
Silber SJ (1984) Microsurgery in the male ductal system. In: Silber SJ, (ed). Reproductive infertility: microsurgery in the male and female. Williams and Wilkins, Baltimore, pp 78–161
Silber SJ (1989a) Pregnancy after vasovasostomy for vasectomy reversal: a study of factors affecting long-term return of fertility in 282 patients followed for 10 years. Human Reprod 4:318–322
Silber SJ (1989b) Results of microsurgical vasoepididymostomy: role of epididymis in sperm maturation. Human Reprod 4:298–303
Silber MD, Balmaceda J, Borrero C, Ord T, Asch R (1988) Pregnancy with sperm aspiration from the proximal head of the epididymis: a new treatment for congenital absence of the vas deferens. Fertil Steril 50:525–528
Soonawalla FB, Lal SS (1984) Microsurgery in vasovasostomy. Ind J Urol 1:104–108
Stanwell-Smith RE, Hendry WF (1984) The prognosis of male subfertility: a survey of 1025 men referred to a fertility clinic. Br J Urol; 56:422–428
Stedronska J, Hendry WF (1983) The value of the mixed antiglobulin reaction (MAR test) as an addition to routine seminal analysis in the evaluation of the subfertile couple. Am J Reprod Immunol 3:89–91
Suominen J, Soderstrom K-O (1982) Lymphocyte infiltration in human testicular biopsies. Int J Androl 5:461–466
Thomas AJ Jr (1987) Vasoepididymostomy. Urol Clin North Am 14:527–538
Tung KSK, Woodroffe AJ (1978) Immunopathology of experimental allergic orchitis in the rabbit. J Immunol 120: 320–328
Urquhart-Hay D (1981) A low-power magnification technique for reanastomosis of the vas. Br J Urol 53:446–469
Wagenknecht LV (1991) Alloplastiche spermatozele erfahrungskericht uber 17 jahre. Urologe (B) 31:7–11
Wagenknecht LV, Lotzin CF, Sommer HJ, Schirren C (1983) Vas deferens aplasia: clinical and anatomical features of 90 cases. Andrologia 15:605–613
Waksman BH (1959) A histologic study of the auto-allergic testis lesion in the guinea pig. J Exp Med 109:311–324
Wallace DMA, Gunter PA, Landon GV, Pugh RCB, Hendry WF (1982) Sympathetic orchiopathia: an experimental and clinical study. Br J Urol 54:765–768
Warkany J (1966) Acrodynia — a postmortem of a disease. Am J Dis Child 112:147–156
Young D (1970) Surgical treatment of male infertility. J Reprod Fertil 23:541–542
Zinner A (1914) Ein fall von intravesikaler samenblasenzyste. Wein Med Wochnschr 64:605–609
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1994 Springer-Verlag London Limited
About this chapter
Cite this chapter
Hendry, W.F. (1994). Azoospermia and Surgery for Testicular Obstruction. In: Hargreave, T.B. (eds) Male Infertility. Springer, London. https://doi.org/10.1007/978-1-4471-1029-3_17
Download citation
DOI: https://doi.org/10.1007/978-1-4471-1029-3_17
Publisher Name: Springer, London
Print ISBN: 978-3-540-76216-4
Online ISBN: 978-1-4471-1029-3
eBook Packages: Springer Book Archive