閉塞性無精子症に対するAlloplastic spermatoceleの使用経験

Abstract

閉塞性無精子症例にWagenknechtらの開発したcup shaped alloplastic spermatoceleを用い精子採取を試みたが充分なものは得られずAIHに供することはできなかった

To perform AIH, an artificial spermatocele was inserted into the epididymis for obstructive azoospermia (probably caused by congenital defect of the spermiduct on one side and by accidental vasosection in hernioplasty on the other). The graft used was a cup-shaped alloplastic spermatocele made of silicon-dacron, developed by Wagenknecht et al. The epididymal duct was incised microscopically. The graft was sutured to the epididymal involucrum, punctured through the scrotal skin by an injection needle and aspirated spermatozoa accumulated in the internal cavity, and subjected to AIH. Postoperatively, acceleration of spermatogenesis was attempted by injecting i.m. HCG 2, 000 U-HMG 150 U twice a week, but spermatozoa both qualitatively and quantatively sufficient to perform AIH could not be obtained. Spermatozoa were no longer found after two and a half postoperative months. Despite the present failure, we would like to develop a method of grafting of this kind as more precise therapeutic means through further technical improvements in grafting.