Reconstruction of seminal ducts in obstructive azoospermia

Depending on the localization of the obstruction of the seminal ducts, eith er a microsurgical reconstruction (tubulovasostomy, vasovasostomy) or a tra nsurethral resection of the ejaculatory ducts is carried out. We have compa red the effectiveness and economic advantages of reconstructive microsurger y of the epididymis and vas deferens with standard procedures in animal exp eriments. Microsurgical invagination techniques in tubulovasostomy are equa l to the standard procedure from the point of view of the patency and ferti lity rates. They are also easier to learn and carry out. Less time is requi red for the invagination technique, and also less microsurgical suture mate rial. The double-laver technique in vasovasostomy is equal to the one-layer microsurgical technique from the point of view of patency and fertility ra tes. The one-layer technique requires less time and suture material. It see ms that the discrepancy between the patency and the fertility rate is relat ed to immunological processes after reconstruction of the seminal ducts. In cases of obstructive azoospermia it is necessary to investigate the indivi dual conditions and possibilities of the infertile couple. As a result of t he high success rate obtainable today by surgical reconstruction of the sem inal ducts, this must constitute the first type of treatment to be consider ed, before any of the procedures of reproductive medicine are undertaken.