男性不妊に対する手術的療法 各種合併症に対する補助的手術療法について

Abstract

Surgical treatments were attempted for 16 cases of ma l e sterility derived from secondary disturbance of spermatogenetic function due to scrotal varicocele, hydrocele, retentio testis and inguinal hernia, accompanied with supportive therapy with administration of gonadotropic hormones, male sexual hormones, thyroid powder, vitamines (B12 and E) and nucleic acid precursors. For 11 ca s es in which varicocelectomy was attempted, the advanced transscrotal varicocelectomy and high ligation were performed in 4 and 7 cases respectively. Out of these 11 cases, increase in number of spermatozoa, ranging from 3 x 106/cc to 24x106/cc after the operation. Conceptions were succeeded in 3 couples. In 2 cases in which hydrocelectomy was p e rformed, improvement of spermatozoa) motility and increase in number of spermatozoa were achieved in a patient with oligozoospermia but no beneficial response was seen after operation in a case of azoosperimia (spermatogenic arrest). In 2 cases d o ne orchidopexy, number of spermatozoa increased from pre-operative value of 6 x106/cc to post-operative value of 34 x 106/cc in one case and from 18 x106/cc to 23 x 106/cc in the other. Conception was succeeded in the former couple. A case of oligonecrospermia due to inguinal hernia, who had 0.5 x 106/cc of spermatozoa, showed an increase in number of spermatozoa to 50 x 106/cc and improvement of motility rate as 85 % after the operation of hernioplasty. Conception was succeeded 8 months after the surgery. For ea c h one case of stone formations in the ejaculatory duct, in the seminal vesicle and ejaculatory duct and pathological dilatation of the ejaculatory duct, complicated, with hemospermia, azoospermia and oligozoospermia, lithotomy and partial excision were performed. Conception was succeeded in the last case aften the operation.