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Multiple factors affecting surgical outcomes and patency rates in use of single-armed two-suture microsurgical vasoepididymostomy: a single surgeon′s experience with 81 patients
- Source :
- Asian Journal of Andrology, Vol 18, Iss 1, Pp 129-133 (2016), Asian Journal of Andrology
- Publication Year :
- 2016
- Publisher :
- Wolters Kluwer Medknow Publications, 2016.
-
Abstract
- Vasoepididymostomy (VE), as the most challenging procedure in microsurgeries, is often carried out with a double-armed two-suture technique. In this study, we evaluated the efficacy and safety of the single-armed two-suture VEs on humans and studied the factors that could possibly affect the patency rates. From July 2012 to July 2013, we reviewed 81 patients with consecutive primary epididymal obstruction who underwent single-armed two-suture longitudinal intussusception microsurgical VEs by a single surgeon, Kai Hong (KH). At the same time, we analyzed seven factors that possibly related to the patency rates. With the single-armed technique, a total of 81 men underwent the microsurgical VEs. Data on 62 patients were completely recorded. 19 patients were lost to follow-up. Mean age was 31 years old. Mean follow-up time was 8.8 (2-17) months. The patency rate was 66.1% (41/62). Natural pregnancy rate was 34.1% (14/41). Overall pregnancy rate was 22.6% (14/62). No severe surgical complications were noted. With logistic regression test analysis, there were two factors related to a higher patency rate: anastomosis sites (P = 0.035) and motile sperm found in the epididymal fluid (P = 0.006). Motile sperm found in the epididymal fluid were associated with a higher patency rate (OR = 11.80, 95% CI = 1.79, 77.65). The single-armed two-suture longitudinal VE technique is feasible for microsurgical practice. The patency and pregnancy rates are comparable to the doubled-armed technique. Anastomosis sites and motile sperm found in the epididymal fluid were the most two important factors related to higher patency.
- Subjects :
- Adult
Male
medicine.medical_specialty
Microsurgery
Urology
medicine.medical_treatment
030232 urology & nephrology
Obstructive azoospermia
Anastomosis
lcsh:RC870-923
male infertility
Male infertility
03 medical and health sciences
0302 clinical medicine
Medicine
Humans
microsurgery
obstructive azoospermia
vasoepididymostomy
Retrospective Studies
Epididymis
Pregnancy
030219 obstetrics & reproductive medicine
Sutures
business.industry
Retrospective cohort study
General Medicine
medicine.disease
lcsh:Diseases of the genitourinary system. Urology
Surgery
Pregnancy rate
Treatment Outcome
Vasoepididymostomy
Original Article
business
Subjects
Details
- Language :
- English
- ISSN :
- 17457262
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Asian Journal of Andrology
- Accession number :
- edsair.doi.dedup.....78565ec210f5f299aa93fb3e6edb7e7f