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Azoospermia with unknown obstruction and normal testiclular function
2019-09-15 16:24
Q:Dr. Lee, I'm a 34-year old Asian male who's suffering from what appears to be Obstructive Azoospermia. Azoospermia was confirmed by sperm analysis that returned no sperm in February. The obstruction was originally thought to be in the left vas deferens as evidenced by a recent microsurgical procedure done in April of this year. The surgery was intended to be Bilateral Epididymovasostomy but upon examination and detection of sperm cells in the left vas and the presence of "sludge", the surgeon decided to physically clear the sludge to improve the flow and did not perform the epididymovasostomy. A sperm analysis was performed one month post-op and it returned zero sperm. In all my sperm analyses since February, the sperm counts were zero with lowered pH (less than 6.0) of the semen. Ejaculate volume was normal to low (less than 2ml). I also noticed that I show chronic hematospermia in that occasionally the ejaculate color appears to be light brown. No pain is associated with ejaculation or immediately after ejaculation but there usually is a pain in the groin area (more specifically in the left vas deferens near the surgical sight) 1-2 days after ejaculation (through sexual intercourse or masturbation). I've also been checking my left vas deferens near the surgical site and it feels enlarged, hard (fibrous), and the pain seems to be coming from there. On a normal day-to-day basis, I experience no groin pain or strange discharge. I also have a congenital condition where the right vas deferens did not connect to the ejaculatory duct. Since the one month post-op follow-up sperm analysis returned no sperm, I've been on prescribed antibiotic and anti-inflammatory medicine (Sulfameth and Prednisone) for almost 6 weeks. I already have one child through normal conception and birth and we've been trying to have a second child for over a year now. I'm interested to know if the Diuretics and Anti-inflammatory pills will address the issue and cure my condition. I also want to know what my condition is. At this point, I'm not sure if there is an obstruction in the vas deferens or if I'm suffering from some kind of chronic prostatitis or seminal vesculitis. Thank you very much.
A:
After reading your words carefully, I have some questions for you. First, you mentioned that you have had pain on your left vas deferens near the surgical site, Maybe you have had a postoperative infection. So I suggest you to take another test to see are there any obstruction in your left vas deferens. 

Second, you mentioned that you have had chronic Hemospermia, have you done any tests to see are they any bad materials in your body like chlamydia infection, mycoplasma infection, trichomonad and so on? If no, please take a test. Don't worry, Diuretic and Anti-inflammatory pills has good effect on treating Hemospermia. 

There are some reasons may cause azoospermia. You are not congenital azoospermia, so the great possible reason is infection. Other possible reasens are: t
 
If you had the obstruction again, I suggest you to try our herbal pill after unblocking the obstruction by surgery, because you need to prevent postoperative infection. Our herbal pill --- Diuretic and Anti-inflammatory pills is capable to prevent the postoperative infection. This herbal pill has many amazing functions like clearing away heat and toxic materials. Thus, it not only have bad materials like chlamydia infection, mycoplasma infection, trichomonad and so on can be cleared, but also can prevent postoperative infection. It has same effect as antibiotic, and has many advantage that antibiotic do not has. 
 
Our herbal pill also is a harmless treatment for men. This herbal pill does not have drug resistance and side –effect, which also is the reason why I do not recommend antibiotic therapy for you to prevent postoperative infection. If you have more questions on this disease or our herbal pill, please feel free to contact with our online doctors. 
 
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