“Shaeer’s vasovasostomy” for bypassing inguinal obstruction of the vas deferens: intra-peritoneal versus extraperitoneal approaches
© Société d’Andrologie de Langue Française 2006
Received: 15 December 2005
Accepted: 15 December 2005
Latrogenic obstruction of the vas deferens within the inguinal canal can be managed by direct onsite vasovasostomy. However, in cases with large defect of the vas, the anastomosis may be under tension. Dissecting through the site of a previous hernia repair is tedious, and may lead to recurrence of the hernia.
Aim of the Work
The present work reports on an alternative technique that avoids the latter drawbacks.
Patients and Methods
A total of 15 patients with azoospermia due to inguinal obstruction of the vas deferens underwent bilateral repair. Ten cases were operated upon using the classical transperitoneal approach. Under laparoscopic vision, the pelvic vas was rendered intraperitoneal and its lateral-most end was clipped at the internal inguinal ring, cut and extruded from the abdomen through a port in the external inguinal ring. Vasovasostomy was performed, bridging the retrieved stump of the pelvic vas with the scrotal vas. Five patients were operated upon through the extraperitoneal approach.
By the end of one year. Nine out of the 15 cases showed an average sperm concentration of 17±3.5 million/ml.
Pelvi-scrotal vasovasostomy (PSVV) or Shaeer’s vasovasostomy can be offered as a cost-effective and successful alternative or supplement to intracytoplasmic sperm injection (ICSI), for cases with iatrogenic large defects of the vas deferens within the inguinal canal. The transperitoneal approach is more convenient in post-herniotomy and post-herniorrhaphy cases.