Rapidly progressing, late-onset obstructive azoospermia linked to herniorrhaphy with mesh

Objective: To report a case of a man presenting with rapidly progressing inguinal vasal obstruction 5 years after bilateral herniorrhaphy with polypropylene mesh. Design: Case report with a review of the scientific literature. Setting: Male infertility clinic, Kobe University Hospital (Kobe, Japan). Patient(s): A 30-year-old patient who had undergone bilateral inguinal herniorrhaphy using polypropylene mesh 5 years previously. Intervention(s): The patient underwent bilateral vasography and left testicular sperm extraction (TESE). Main Outcome Measure(s): Long-term effects of the adult inguinal herniorrhaphy with polypropylene mesh. Result(s): Rapid progression of vas deferens obstruction occurred within several months. We performed left TESE for intracytoplasmic sperm injection (ICSI) and retrieved many motile sperm. Conclusion(s): Before azoospermia, men who undergo inguinal herniorrhaphy using polypropylene mesh need to rapidly cryopreserve their sperm for future fertility; TESE-ICSI is also a selectable treatment. (Fertil Steril (R) 2008;90:2018.e5-e7. (C) 2008 by American Society for Reproductive Medicine.)