Causes of suspected epididymal obstruction in Chinese men

Abstract

Objective: To explore the causes of epididymal obstruction in China and the success of reconstructive surgery.

Materials and methods: From February 2006 to December 2009, 134 consecutive azoospermic men with suspected epididymal obstruction underwent scrotal exploration. We excluded 11 men who had undergone vasectomy and 5 with inguinal hernia repair. The findings of scrotal exploration and outcomes of reconstructive surgery were reviewed.

Results: Epididymal obstruction was found in 162 of 258 (62.8%) suspected blocked reproductive tract units (2/patient). The etiology of obstruction was idiopathic for 144 units (88.9%), infection for 16 (9.9%), and surgical for 2 (1.2%). The etiology for the remaining 96 obstructed units (37.2%) was intratesticular obstruction for 59 (61.5%), vasal obstruction for 24 (25%) and vasal atresia for 13 (13.5%). Of the 134 patients, we identified sperm in the epididymis on ≥ 1 side in 96 (71.6%). These 96 patients underwent vasoepididymostomy, and 46 (63.9%) had sperm on postoperative ejaculation.

Conclusion: Idiopathic obstruction was the most common cause of epididymal obstruction in this Chinese sample, which differed from the U.S. experience. Microsurgical vasoepididymostomy is effective for idiopathic epididymal obstruction.