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    Reconstructive surgery in male infertility: The technique and predictive parameters [Erkek infertilitesinde rekonstrüktif cerrahi: Teknik ve prediktif ölçütler]
    (2006) Tezer H.M.; Güven S.; Ersay A.; Erol B.; Kadio?lu A.
    Introduction: The aim of infertile male evaluation is to unveil the etiology of infertility and plan the specific treatment according to the etiology. In case there is not a specific treatment the aim is to refer to assisted reproductive techniques. However the etiology specific treatment of male infertility, compared to the assisted reproductive techniques is more cost effective and it does not have the risks of assisted reproductive techniques. Materials and Methods: The obstruction of the sperm ducts is one of the correctable causes of male infertility and the treatment varies according to the localization of obstruction. When there is distal ejaculatory duct pathology the treatment choice is TUR-ED while in proximal ejaculatory duct patologies reconstructive treatment is the preferred choice (vasovasostomy/epididymovasostomy). Peroperative semen freezing is offered to the patient as there is a risk of recurrence. Results: The reconstructive surgery of ductal system has been improved through years and so has the operation success. The success of the operation is to provide a ductal patency and pregnancy. The milestone of operative technique is the use of the microscope. With the use of the microscope the obstruction is localized more effectively and the anastomoses are made according to the anatomy. Consecuently, the success of the operation is higher. Conclusion: The success rate of the operation, on behalf of the development of the operational technique, depends on the choice of the right patient. In order to predict the success of the operation some parameters were tried to be established in some studies. It was stated that some preoperative and peroperative parameters have predictive importance.