Vasography
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Vasography is an X-ray study of the vas deferens to see if there is blockage, oftentimes in the context of male infertility.[1] An incision is made in the scrotum, contrast is injected in the vas deferens, and X-rays are taken from different angles.[1] Thus, it is an invasive procedure and carries risk of iatrogenic scarring and obstruction of the vas.[2] Vasography has traditionally been considered the gold standard imaging modality for evaluating the seminal tract patency.[3]
To avoid performing an extra operation, vasography is encouraged to be done at the time of correction of the obstruction, and thus should not be done as an isolated outpatient procedure.[2]
Vasography was first described by Belfield in 1913, where a vasotomy was initially done and the vas deferens was subsequently intubated.[4][5] After almost 40 years of being overlooked, Boreau revived the procedure in the 1950s.[4] Then, vasography was somewhat overused for various fertility disorders and other diseases such as tuberculosis, prostate cancer, hemospermia, and compressive fibrolipomatosis, without considering the possible risks and complications from the procedure.[4] Today, vasography is used to determine the location of obstruction in azoospermic patients who have demonstrated spermatogenesis by testis biopsy.[6]