Patency rates of microsurgical vasoepididymostomy for patients with idiopathic obstructive azoospermia: a prospective analysis of factors associated with patency--single-center experience

Urology. 2012 Jan;79(1):119-22. doi: 10.1016/j.urology.2011.09.034.

Abstract

Objective: To evaluate the factors that might be associated with the patency rates of microsurgical vasoepididymostomy for idiopathic obstructive azoospermia.

Methods: From January 2009 to July 2010, we evaluated the data from 73 men with obstructive azoospermia who had undergone longitudinal intussusception vasoepididymostomy. The mean age was 30.9±4.9 years (range 22-48). The outcomes were analyzed by the pre- or intraoperative clinical findings: epididymal fullness, unilateral or bilateral procedure, site of anastomosis, and epididymal fluid findings.

Results: The mean follow-up was 13.5±5.3 months (range 4-22) for 53 patients (72.6%). The overall patency rate was 71.7% (n=38). The patency rate was 87.2%, 80.7%, 78.8%, 100%, and 83.7% for epididymal fullness, bilateral surgery, corpus anastomosis, caudal anastomosis, and flowing fluid with motile sperm, respectively. The natural pregnancy rate was 33.3% at a mean of 9.9±4.2 months of follow-up.

Conclusion: Longitudinal intussusception vasopididymostomy can provide a good patency rate, with success associated with epididymal fullness, bilateral surgery, distal epididymal anastomosis, and flowing fluid with motile sperm.

MeSH terms

  • Adult
  • Anastomosis, Surgical / methods
  • Azoospermia / diagnosis
  • Azoospermia / surgery*
  • China
  • Cohort Studies
  • Constriction, Pathologic / surgery
  • Epididymis / physiopathology
  • Epididymis / surgery*
  • Follow-Up Studies
  • Humans
  • Infertility, Male / diagnosis
  • Infertility, Male / surgery
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Prospective Studies
  • Risk Assessment
  • Time Factors
  • Treatment Outcome
  • Urogenital Surgical Procedures / methods*
  • Vas Deferens / surgery
  • Vasovasostomy / methods
  • Young Adult