535 A novel therapeutic method for azoospermia resulted from distal deferential obstruction

Abstract

To evaluate the efficiency of the therapeutic method using seminal vesiculoscope with holmium laser to treat azoospermia resulted from distal deferential obstruction. We recruited 6 obstructive azoospermia (OA) patients from the Andrology Clinic. All cases were diagnosed as OA caused by distal deferential obstruction via 3 consecutive semen analyses, trans-rectal B-type ultrasound and pelvic MRI. Then we performed transurethral seminal vesiculoscopy for all patients, and treated the local lesions at the distal part of deferential duct using holmium laser. Cysts with calcification at the ejaculatory ducts were found in ultrasound images in 4 of 6 patients, and the other 2 cases suffered from the unexplained stenosis of vas deferens ampulla, which resulted in the obvious dilation of proximal part. During the operation, we firstly inserted the seminal vesiculoscope into the prostatic utricle, and then decorticated the cysts located at the ejaculatory duct or resected the scars at the ampulla of deferens duct using holmium laser. Motile sperms were found in 5 of 6 patients’ semens three months after the operations. Negative sperm in semen happened in only one patient with severe long stenosis of the vas deferens ampulla.