Obstructive azoospermia is a type of azoospermia caused by obstruction of the vas deferens, which hinders the transportation of sperm. The incidence of obstructive azoospermia in male infertility is approximately 1%. Among azoospermia patients, the proportion of male infertility caused by obstructive azoospermia is relatively high, accounting for 42.4% -48%. So how much is the surgery for obstructive azoospermia? Let's take a look with the editor of 592 Baobao Net.

There are generally three ways to treat obstructive azoospermia: physical therapy, drug therapy, and surgical treatment. The cost of the surgery ranges from 4000 to 12000 yuan. The cost of medication and physical therapy is relatively low at around a thousand yuan.

Different treatment methods for obstructive azoospermia

1) Intratesticular obstruction.

Due to the inability to perform this surgery, TESE or fine needle aspiration is usually used to extract testicular sperm. The obtained sperm should be immediately subjected to ICSI or cryopreservation. TESE or fine needle aspiration can be applied to all obstructive azoospermia.

2) Obstruction of the epididymis.

CBAVD is commonly used in microsurgical epididymal sperm aspiration (MESA), and the obtained sperm is typically used for ICSI treatment. Generally speaking, the sperm obtained from one MESA is sufficient for multiple ICSI cycles. For acquired epididymal obstruction, microsurgical microscopy or end-to-end epididymal vas deferens anastomosis can be used. The recovery rate of microsurgery is 60-87%, and the cumulative pregnancy rate is 10-43%.

3) Obstruction of the proximal vas deferens.

Intravas deferens anastomosis is only suitable for a few patients, and proximal obstruction after vas deferens resection requires microsurgical treatment. During the operation, sperm cannot be detected in the vas deferens fluid, confirming the presence of secondary epididymal obstruction, especially when toothpaste like "tooth paste" viscous fluid appears in the proximal vas deferens fluid, vas deferens epididymostomy should be performed.

4) Distal obstruction of the vas deferens.

Hernia or testicular descent fixation surgery performed in childhood results in extensive defects of both vas deferens, which are usually unable to be reconstructed. This type of patient should extract sperm from the proximal vas deferens and undergo ICSI using MESA. If the vas deferens and vas deferens are inactivated with ipsilateral testicular atrophy, vasectomy or epididymostomy can be considered.

5) Ejaculatory duct obstruction.

The treatment of ejaculatory obstruction depends on the cause, with extensive inflammatory obstruction. One or both ejaculatory ducts are connected to the central axis prostate cyst. Transurethral ejaculatory duct resection (TURED) can partially remove the seminal port, while partial central axis prostate cysts should be removed or removed. TURS can make the surgery safer.

Patients with obstructive azoospermia, whose testicles still have the ability to produce normal sperm, can undergo surgery such as vas deferens recanalization to restore the obstructive vas deferens and ensure that the semen contains sufficient quantity and quality of sperm to achieve normal pregnancy. If no sperm is found in the semen, sperm can be extracted through testicular or epididymal puncture, and then undergoing in vitro fertilization treatment.