Skip to main content

Advertisement

“Shaeer’s vasovasostomy” for bypassing inguinal obstruction of the vas deferens: intra-peritoneal versus extraperitoneal approaches

Article metrics

  • 180 Accesses

Abstract

Introduction

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.

Results

By the end of one year. Nine out of the 15 cases showed an average sperm concentration of 17±3.5 million/ml.

Conclusion

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.

References

  1. 1.

    ANTHONY K., DAVID S., THOMAS M. STANTON H.: Laparoscopic mobilization of the retroperitoneal vas deferens for microscopic inguinal vasovasostomy. J. Urol., 2004, 172: 1948–1949.

  2. 2.

    HENDRY W.: Testicular obstruction: clinicopathological studies. Ann. R. Coll. Surg. Engl., 1990, 72: 396–407.

  3. 3.

    MATSUDA T.: Diagnosis and treatment of postherniorrhaphy vas deferens obstruction. Int. J. Urol., 2000, 7 (Suppl): 35–38.

  4. 4.

    SHAEER O.K.Z., SADAT A., SHAEER, K.Z.: Laparoscopy and microsurgery aided pelvi-scrotal vasovasostomy “Shaeer’s Vaso-vasostomy”. Egy. J. Androl. Reprod., 2003, 17: 37–42.

  5. 5.

    SHAEER O.K.Z., SHAEER, K.Z.: Laparoscopy-assisted pelviscrotal vasovasostomy. Andrologia, 2004, 36: 311–314.

  6. 6.

    SHAEER O.K.Z., SHAEER, K.Z.: Pelviscrotal vasovasostomy: refining and troubleshooting. J. Urol., 2005, 174: 1935–1937.

  7. 7.

    STALF T.: Influence of motility and vitality in intracytoplasmic sperm injection with ejaculated and testicular sperm. Andrologia, 2005, 37: 125–130.

Download references

Author information

Correspondence to Osama K. Z. Shaeer.

Additional information

Invited Speaker at the XXIInd SALF Meeting, Marseille 2005

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Shaeer, O.K.Z. “Shaeer’s vasovasostomy” for bypassing inguinal obstruction of the vas deferens: intra-peritoneal versus extraperitoneal approaches. Androl. 16, 50–52 (2006) doi:10.1007/BF03034832

Download citation

Key words

  • vas deferens
  • inguinal
  • obstruction
  • vasovasostomy
  • hernia