Patel Sutchin R, Sigman Mark
Division of Urology, Brown Medical School, Providence, Rhode Island 02905, USA.
J Urol. 2008 Jan;179(1):256-9. doi: 10.1016/j.juro.2007.08.169. Epub 2007 Nov 14.
We compared postoperative semen analysis parameters and patency rates of vasovasostomy performed in the convoluted vs straight portion of the vas deferens.
Records of patients that underwent bilateral vasovasostomy in the straight and convoluted vas deferens by a single surgeon were retrospectively analyzed. Patient age, partner age, obstructive interval, gross and microscopic appearance of the intraoperative fluid aspirated from the testicular portion of the vas deferens, and postoperative semen analysis results were examined. Patency was defined as any sperm in the postoperative ejaculate and was compared for the 2 groups.
A total of 42 and 64 patients underwent bilateral straight vasovasostomy and convoluted vasovasostomy, respectively. Mean patient age for straight and convoluted vasovasostomy was 38.5 and 40.3 years, respectively. Mean obstructive interval for straight vasovasostomy and convoluted vasovasostomy was 7.7 and 8.6 years, respectively. No significant differences in the postoperative semen analysis parameters of volume, total count, sperm density, motility or total motile count were found between the 2 groups. The patency rate was 98.1% and 97.3% for convoluted vasovasostomy and straight vasovasostomy, respectively, and was not statistically different.
Although vasovasostomy in the convoluted vas deferens is considered technically more challenging than in the straight vas deferens, patency rates and postoperative semen analysis parameters for convoluted vasovasostomy and straight vasovasostomy are comparable.
我们比较了在输精管蟠曲部与直部进行输精管吻合术后的精液分析参数及通畅率。
回顾性分析由同一位外科医生在输精管直部和蟠曲部进行双侧输精管吻合术的患者记录。检查患者年龄、配偶年龄、梗阻时间、从输精管睾丸端吸出的术中液体的大体及显微镜下表现,以及术后精液分析结果。通畅定义为术后射精中有任何精子,并对两组进行比较。
分别有42例和64例患者接受了双侧输精管直部吻合术和蟠曲部吻合术。输精管直部吻合术和蟠曲部吻合术患者的平均年龄分别为38.5岁和40.3岁。输精管直部吻合术和蟠曲部吻合术的平均梗阻时间分别为7.7年和8.6年。两组术后精液分析参数中的体积、总数、精子密度、活力或总活动数均未发现显著差异。输精管蟠曲部吻合术和直部吻合术的通畅率分别为98.1%和97.3%,无统计学差异。
尽管输精管蟠曲部的输精管吻合术在技术上被认为比直部更具挑战性,但输精管蟠曲部吻合术和直部吻合术的通畅率及术后精液分析参数相当。