Abstract
The scrotum was explored in 32 patients who had vasectomy reversal which failed to restore their fertility. 23 patients were azoospermic and 9 had severe or persistent oligozoospermia. Among the 23 azoospermic cases the vasa were found to be blocked in 12; following repeat vaso-vasostomy normal sperm counts were produced in 10 patients; 8 of these patients followed up for 6 months or more successfully impregnated their wives. In 4 cases there was a secondary epididymal block; following epididymo-vasostomy 3 of 4 patients otained normal sperm counts and 2 wives became pregnat. In 7 patients there was a very high antisperm antibody titstet (<1024 by tray agglutination test) and despite reparative surgery and prednisolone therapy no pregnancies were obtained. The overall pregnancy rate for this group was 7 of 19 (37%). Anong 9 oligozoospermic cases unilateral obstruction was found in 8. The block was found in the vas in 5 and in the epididymis in 2 and in 2 there were very high antisperm antibody titers. After reconstructive surgery 4 patients had normal sperm counts and 1 pregnancy has been obtained. (authors)
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