Management of obstructive azoospermia

Question 1

scrotal vasovasostomy and vasoepididymostomy are performed through

Answer 1

2-3cm vertical incisions through the anterior hemiscrotum

Question 2

when is the decision to perform a vasovasostomy or vasoepidymostomy made for a vasectomy reversal?

Answer 2

intraoperatively

Question 3

single most important determinant of whether vasovasostomy or vasoepididymostomy are performed

Answer 3

quality of the vasal fluid

Question 4

vasovasostomy should be performed for

Answer 4

grade 1-4 vasal fluid or grade 5 (no sperm) when vasal fluid is watery and copious

Question 5

vasoepididymostomy should be performed for

Answer 5

grade 5 (no sperm) and when vasal fluid is thick and creamy

Question 6

prior to anastamosis, patency of the distal length of the vas deferens should be confirmed by performing

Answer 6

a saline vasogram

Question 7

postoperative recovery for vasectomy reversal

Answer 7

3-4 weeks

Question 8

vasectomy reversal is considered to have failed if sperm do not return to ejaculate by

Answer 8

6 months for vasovasostomy or 18 months for vasoepididymostomy

Question 9

significant decline in pregnancy rates seen when vasectomy to reversal interval is greater than

Answer 9

15 years

Question 10

if vasectomy reversal fails, options include

Answer 10

reoperation or sperm retrieval with IVF/ICSI

Question 11

for MESA, best sperm quality is found

Answer 11

near the testis in the proximal epididymis

Question 12

best clinical pregnancy rates for sperm retrieval techniques

Answer 12

MESA

Question 13

ejaculatory duct obstruction (EDO) can be relieved by

Answer 13

transurethral resection of the ejaculatory ducts (TURED)

Question 14

average time to pregnancy after vasectomy reversal

Answer 14

12 months

Question 15

sperm retrieval with IVF/ICSI is preferred when

Answer 15

DOR, coexisting female factors that require IVF