Matsuda T, Horii Y, Nonomura M, Nishimura K, Yoshida O
Department of Urology, Faculty of Medicine, Kyoto University.
Hinyokika Kiyo. 1991 Jun;37(6):607-12.
The surgical procedures and results of microsurgical epididymovasostomy for obstructive azoospermia at the epididymis are reported. These procedures include the separation of a single epididymal tubule, an incision in the side wall, and a side-to-end anastomosis to the mucosa of the vas deferens under microscopic view. The tunica of the epididymis and the muscle layer of the vas are sutured together to support the mucosal anastomosis. Ten patients with epididymal obstruction underwent the side-to-end epididymovasostomy. The group consisted of two with Young's syndrome, one with an epididymal blow-out after vasectomy, one unsuccessful epididymoepididymostomy, 4 after epididymitis and 2 cases of unknown origin. After the operation, sperm appeared in 9 patients, and semen quality was normalized in 4 patients, all of whom impregnated their wives. Microsurgical side-to-end epididymovasostomy is a much easier procedure than Silber's specific tubule method, and results in a high success rate.
本文报道了针对附睾梗阻性无精子症的显微外科附睾输精管吻合术的手术步骤及结果。这些手术步骤包括分离单个附睾小管、在侧壁做切口，并在显微镜下将其与输精管黏膜进行端侧吻合。附睾白膜和输精管肌层缝合在一起以支撑黏膜吻合。10例附睾梗阻患者接受了端侧附睾输精管吻合术。该组患者包括2例杨氏综合征患者、1例输精管切除术后附睾破裂患者、1例附睾-附睾吻合术失败患者、4例附睾炎后患者以及2例病因不明患者。术后，9例患者出现精子，4例患者精液质量恢复正常，且均使妻子受孕。显微外科端侧附睾输精管吻合术比西尔伯的特定小管法操作更简便，成功率高。
