Surgical Procedures for Infertility in Men
Surgery may be performed to treat obstructions in the male reproductive tract or to correct varicoceles.
Surgical procedures include:
This is a microsurgical procedure used to correct obstructions in the epididymis—the coiled tube that connects the testes with the vas deferens (sperm-carrying tubes). These obstructions may be caused by congenital abnormalities, infections (particularly ]]>chlamydia]]> or ]]>tuberculosis]]> ), previous surgeries, or a ]]>vasectomy]]> .
Varicoceles are a common condition characterized by dilation of the veins that drain the testes. They often develop after puberty, although many are not detected until evaluation for fertility problems is undertaken. Varicoceles are the most common cause for male infertility, accounting for up to 40% of cases. Not all varicoceles require treatment, although most doctors recommend treating varicoceles if you are experiencing infertility. Even though they do not represent a health risk, they can contribute to deterioration of fertility over time.
This surgery is typically performed as an outpatient procedure and consists of a small incision just below the groin. The procedure may be performed under local or general anesthesia. The surgeon may use a microscope to find and preserve the tiny arteries that transport blood to the testes. ]]>Laparoscopy,]]> which involves inserting a thin tube mounted with a video camera through a small abdominal incision, can also be used to repair varicoceles.
Tubal Reconstructive Surgery
In women with either tubal or pelvic disease as the cause of their infertility, reconstructive surgery could be performed. Using a laparoscope, scar tissue can be removed and any blocked tubes can be opened. Also, the use of a hysteroscope in the uterus is used to remove any polyps or fibroid tumors and any scar tissue blocking the tubes.
Current Surgical Diagnosis and Treatment. 11th ed. Appleton & Lange; 2002.
Donkol Rh, Salem T. Paternity after varicocelectomy: preoperative sonographic parameters of success. J Ultrasound Med. 2007;26:593-599.
Goldstein M, Tanrikut C. Microsurgical managmenet of male infertility. Nat Clin Pract Urol. 2006;3:381-391.
The International Council on Infertility Information Dissemination, Inc. website. Available at: http://www.inciid.org/ .
Practice Committee of the American Society for Reproductive Medicine. The role of tubal reconstructive surgery in the era of assisted reproductive technologies. Fertil Steril. 2006;86:S31-4.
RESOLVE. The National Infertility Association website. Available at: http://www.resolve.org/ .
Last reviewed November 2008 by ]]>Adrienne Carmack, MD]]>
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