A modified transversal two-suture microsurgical intussusception vasoepididymostomy for the treatment of epididymal obstructive azoospermia

Liu, Zengqin1,2,3; Ding, Zheng1,2,4; Jiang, Hongtao1,2,3; Yuan, Qian1,2,3; Xiao, Kefeng1,2,3; Wang, Bin5,6

2022-12-01

10.1159/000528391

EUROPEAN SURGICAL RESEARCH   Impact Factor & Quartile

0014-312X

1421-9921

Introduction: We have developed a modified vasoepididymostomy procedure, namely "fenestrated" transversal two-suture microsurgical intussusception vasoepididymostomy. This study aimed to investigate the therapeutic efficacy and outcome of this fenestrated vasoepididymostomy for epididymal obstructive azoospermia. Methods: Microsurgical two-suture transversal intussusception vasoepididymostomy was performed using our modified fenestration technique in 64 obstructive azoospermia (OA) patients due to epididymal obstruction at our hospital. Fenestration means making an opening on the epididymal tubule wall. The edges of the epididymal tubule "window" were stitched transversally (2 stitches) using the two double-armed 9-0 atraumatic suture. The epididymal tubule was anastomosed to the lumen of the vas deferens. The patency rate and pregnancy rate were assessed. Results: Of the 64 OA patients, 45 received bilateral microsurgical two-suture transversal intussusception vasoepididymostomy while 19 underwent unilateral microsurgical two-suture transversal intussusception vasoepididymostomy. All of the patients were followed up after the operation. The follow-up period ranged from 4 to 54 months. Among 45 cases of bilateral surgery, the patency rate was 88.89% (40/45), and the natural pregnancy rate was 28.89% (13/45). After the patency was confirmed postoperatively, 3 cases had recurrent OA, of which 2 cases had return of sperm to the ejaculate by oral antibiotics and scrotal self-massage. As for the 19 cases of unilateral microsurgery, the patency rate was 68.42% (13/19), and the natural pregnancy rate was 21.05% (4/19). Conclusion: The fenestrated transversal two-suture microsurgical intussusception vasoepididymostomy can achieve a good patency rate in OA patients, and did not increase the difficulty and duration of the procedure.

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English

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Medical Scientific Research Foundation of Guangdong Province, China[B2020197] ; Research Projects Of Shenzhen Health System in 2017[SZLY2017021]

Surgery

Surgery

WOS:000905503700001

KARGER

Web of Science

1.Jinan Univ, Shenzhen Peoples Hosp, Clin Med Coll 2, Dept Urol, Shenzhen 518020, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen 518020, Guangdong, Peoples R China
3.Shenzhen Peoples Hosp, Shenzhen Engn & Technol Ctr Minimally Invas Urol, Shenzhen 518020, Guangdong, Peoples R China
4.Jinan Univ, Clin Med Coll 2, Dept Urol, Guangzhou, Peoples R China
5.Fujian Med Univ, Union Hosp, Dept Urol, Fuzhou, Peoples R China
6.Fujian Med Univ, Union Hosp, Dept Urol, 29 Xinquan Rd, Fuzhou 350001, Peoples R China

Liu, Zengqin,Ding, Zheng,Jiang, Hongtao,et al. A modified transversal two-suture microsurgical intussusception vasoepididymostomy for the treatment of epididymal obstructive azoospermia[J]. EUROPEAN SURGICAL RESEARCH,2022.

Liu, Zengqin,Ding, Zheng,Jiang, Hongtao,Yuan, Qian,Xiao, Kefeng,&Wang, Bin.(2022).A modified transversal two-suture microsurgical intussusception vasoepididymostomy for the treatment of epididymal obstructive azoospermia.EUROPEAN SURGICAL RESEARCH.

Liu, Zengqin,et al."A modified transversal two-suture microsurgical intussusception vasoepididymostomy for the treatment of epididymal obstructive azoospermia".EUROPEAN SURGICAL RESEARCH (2022).