The Subfertile Man: A Study of Certain Aspects

Scott, L. Stuart (1960) The Subfertile Man: A Study of Certain Aspects. MD thesis, University of Glasgow.

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Contrary to current belief, an appreciable number of azoospermic males with normal-sized testes have histological evidence of complete germinal failure or maturation arrest; the remainder have normal spermatogenesis indicating an obstruction between the testes and the ejaculate. Obstructive azoospermia may result from a congenital defect in the seminal conducting tubules; from previous inflammation; from inadvertent or purposeful damage to the vasa; or, rarely, from tumour growth in the spermatic cord. Aplasia, atresia and congenital absence of the vasa are not as rare as the literature would suggest. Many cases of obstructive azoospermia have no demonstrable obstruction. Some have a block in the tubules of the epididymal tail revealed by dilatation of the tubules in the head; others have a block between the testes and the epididymes, and have no dilated tubules. The former cases are suitable for epididymo-vasostomy, but no known treatment can improve the latter. Patency can frequently be restored to a vas that has been surgically divided, but is less likely to follow re-anastomosis of a vas that has been inadvertently damaged at a previous operation. Bpididymo-vasostomy can overcome an obstruction in the terminal vas or epididymal tail, but return to acceptable 'fertility' is uncommon. Many anastomoses will eventually stenose, and a more prolonged follow-up of these cases is recommended before labelling them as 'successes'.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Medicine
Date of Award: 1960
Depositing User: Enlighten Team
Unique ID: glathesis:1960-79352
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 05 Mar 2020 10:38
Last Modified: 05 Mar 2020 10:38

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