Department of Urology, People Hospital, Peking University, Beijng
Objective: To evaluate the clinical outcomes of surgical
treatment on epididymal obstructive azoospermia (EOA) and
the factors affecting clinical results.
Methods: We retrospectively analysed the datas of 51 OA
patients who underwent a single layer longitudinal 2-suture
intussusception vasoepididymostomy (LIVE) between 2000 and
2007. Data collected included technique, months of followup,
postoperative motile sperm count (MSC) per ejaculate and
percent of progressive motile sperm (PMS). Patency and
pregnancy rates were followed.
Results: With extradural anaesthesia, a total of 51 men
underwent scrotal exploration. Bilateral epididymal obstructions
were comfirmed in 50, while obstructions at epididymis and
contralateral vas deferens in 1. Bilateral and unilateral LIVE were
performed in 42 and 6 men, respectively. 44 were followed for
more than 6 mounths and 39 for more than 1 year. The overall
patency and pregnancy rates were 72.7% and 25.6%, respectively.
Moreover, progressive motile sperm (PMS) were more often
present in those undergoing LIVE at cauda than at corpus or
caput. And pregnancy achieved only in those undergoing LIVE
at least at 1 side of cauda epididymis.
Conclusions: Loupe-assisted LIVE, with lower cost and
simplified surgical procedure, can achieve optimistic patency
outcomes and pregnancy results. Datas of this paper also suggest
that the outcomes as LIVE at cauda epididymis are superior to
that at corpus or caput.