Microsurgical treatment of obstructive azoospermia: a report of 76 cases / 中华男科学杂志
National Journal of Andrology
; (12): 239-244, 2015.
Article
in Zh
| WPRIM
| ID: wpr-319512
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical effect of microsurgical vasoepididymostomy and/or vasovasostomy in the treatment of obstructive azoospermia.</p><p><b>METHODS</b>This study included 76 patients with obstructive azoospermia, 53 treated by bilateral vasoepididymostomy (8 involving the epididymal head, 18 involving the epididymal body, 5 involving the epididymal tail, and 22 involving the epididymal head, body and tail), 14 by unilateral vasoepididymostomy, and the other 9 by unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis). We followed up the patients for 2 to 16 months for the patency rate, routine semen parameters, and pregnancy outcomes.</p><p><b>RESULTS</b>The success rate of bilateral vasoepididymostomy, unilateral vasoepididymostomy, and unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis) were 62.26% (33/53), 35.71% (5/14), and 77.78% (7/9), respectively. The average sperm concentrations in the three groups of patients were (27.9 +/- 5.74), (11.8 +/- 8.33), and (19.9 +/- 7.53) x 10(6)/ml, the average total sperm counts were (65.6 +/- 13.71), (28.0 +/- 15.86), and (69.2 +/- 28.59) x 10(6), and the mean rates of progressively motile sperm were (22.3 +/- 3.18), (11.0 +/- 9.77), and (15.8 +/- 5.05)%, respectively. The success rates of bilateral vasoepididymostomy that involved the epididymal head, body, tail, and all the three parts were 62.5, 72.22, 60, and 54.55%, respectively. Natural pregnancy was achieved in 8 (10.53%) of the total number of cases.</p><p><b>CONCLUSION</b>Microsurgery is effective for the treatment obstructive azoospermia. Unilateral vasoepididymostomy + unilateral vasovasostomy is superior to the other procedures, followed by bilateral vasoepididymostomy. Bilateral vasoepididymostomy involving the epididymal body may achieve a slightly better effect than that involving the other epididymal parts.</p>
Full text:
1
Database:
WPRIM
Main subject:
Sperm Count
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General Surgery
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Vas Deferens
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Anastomosis, Surgical
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Vasovasostomy
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Treatment Outcome
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Pregnancy Rate
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Epididymis
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Azoospermia
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Infertility, Male
Limits:
Adult
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Female
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Humans
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Male
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Pregnancy
Language:
Zh
Journal:
National Journal of Andrology
Year:
2015
Document type:
Article