Hernia Research Today is a free monthly online journal that collates and summarizes the latest research about Hernia, including details on hiatal, inguinal, umbilical, abdominal, treatment.

Laparoscopic retrieval of retroperitoneal vas deferens in vasovasostomy for postinguinal herniorrhaphy obstructive azoospermia.

Nagler HM, Belletete BA, Gerber E, Dinlenc CZ

Department of Urology, Beth Israel Medical Center, New York, New York, USA.

OBJECTIVE: Iatrogenic injury to the vas deferens is a well-documented complication of inguinal hernia repair. Recently obstruction related to the use of polypropylene mesh for hernia repair has been reported. We describe a case using laparoscopy to mobilize the retroperitoneal vas and deliver it to the healthy vas proximal to the vas trapped in the cicatrix induced by mesh thus allowing a tension-free microsurgical repair. DESIGN: Case report. SETTING: Outpatient male infertility practice. PATIENT(S): Obstructed azoospermic men with polypropylene mesh. INTERVENTION(S): Laparoscopic retrieval of retroperitoneal vas segment for primary microsurgical anastomosis. MAIN OUTCOME MEASURE(S): Patency of vas and presence of sperm. RESULT(S): A tension-free, patent anastomosis was performed. CONCLUSION(S): Polypropylene mesh-induced fibrosis of the vas deferens can result in obstructive azospermia. Laparoscopy can be used to permit a microsurgical bypass of the obstructed segment.

Published 13 June 2005 in Fertil Steril, 83(6): 1842.
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