Implantation of artificial spermatocele with cup-shaped prosthesis for excretory azoospermia and chemical management of aspirated spermatozoa.

A cup-shaped silicon prosthesis was developed to treat patients with excretory azoospermia and chemical management of the aspirated spermatozoa was attempted prior to cervical insemination of the wives. These cup-shaped prostheses were implanted eight times in six patients, four of whom had congenital absence and two of whom had bilateral inflammatory obstruction of the vas deferens. The surgical technique was based on the method of Cruz (1980), which involved wrapping the tunica vaginalis over the top of the prosthesis. Aspirated spermatozoa were incubated in a modified Ringer's solution at 37 C for 30 minutes and used for the cervical insemination of the wives. Epididymal spermatozoa could be collected from all patients 10 to 20 weeks after the operation. The percentage of motile aspirated spermatozoa ranged from 0 to 20%. In two cases, the percentage of motile spermatozoa aspirated from the prosthesis increased markedly from 5 and 10% to 55 and 60%, respectively, after incubation of the spermatozoa in the medium. Cervical inseminations were tried in all of the wives from two to four times, but no pregnancy resulted during this study.