(248) Utility of Fine-needle Vasography in Men with Obstructive Azoospermia

Abstract Introduction Obstructive azoospermia accounts for up to 14% of patients presenting fertility evaluation. Fine-needle vasography (FNV) is a diagnostic procedure that can be performed identify an obstruction proximal the ejaculatory duct. Compared traditional vasography, FNV utilizes less-invasive method perform imaging vas deferens and distal structures. Herein we report our experience performing in series with suspected complete or near-complete obstruction. Objective To using site determine candidacy reconstructive procedures obstructive cryptozoospermia. Methods We multi-Institutional case partial azoospermia. Patients were included had severe oligoasthenospermia, presence palpable vasa, testicles ≥12 ml, FSH <7.6 IU/L. All underwent testicular biopsy prior at time confirm spermatogenesis. was 25F angiocatheter, radio-opaque dye visualized under fluoroscopy. Descriptive statistics are reported as median interquartile range (IQR). Results A total 16 between 2014 2022 three surgeons. Twelve presented azoospermia, four oligoasthenospermia. Median age 35.0 (IQR 17) years. pre-vasography semen parameters sperm concentration 0 million/mL 0.3), motility 0% 1), volume 2.5 mL 2.5), pH 8.0 (0.7). testosterone 445 ng/dL 433), 4.5 IU/L 3.6). Half history inguinal hernia repair, unilateral two bilateral six cases. History genitourinary infection present (35.3%) patients. 7 (44%) men found have on FNV, while 8 (50%) offered epididymovasal reconstruction. Of seven diagnosed obstruction/atresia within canal and/or pelvis, only related repair. eight repairs, confirmed level canal. infection, epididymis (with normal FNV), atresia pelvis. Conclusions effective, minimally-invasive way It additionally permits identification who candidates epididymovasostomy reconstruction helps differentiate duct other causes blockage. Disclosure No