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Diagnosis and treatment of obstructive azoospermia.

Obstructive azoospermia is an important reason for male infertility. The obstruction can be caused by congenital, postinflammatory or iatrogenic factors (herniotomy, orchidopexy, vasectomy). Diagnosis includes anamnesis, physical examination, determination of hormone levels (FSH, LH, testosterone), semen analysis and biopsy from both tests. 37 patients with suspected obstructive azoospermia and 19 patients after previous vasectomy underwent scrotal exploration. Following an intraoperative semen analysis, vasoepididymostomy was performed in 12 patients, vasovasostomy in 19 patients. After vasoepididymostomy, patency was stated in 42%, and pregnancy followed in 17%. The patency after vasectomy reversal was 85%. The success of treatment of obstructive azoospermia depends on the duration of obstruction, on the location and on the microsurgical technique applied.