Hussein Alayman
Urology Department, Minia University, El-Minia, Egypt.
BJU Int. 2015 Apr;115(4):653-8. doi: 10.1111/bju.12839. Epub 2014 Oct 20.
To describe and evaluate the outcomes of a new epididymovasostomy technique.
Nine patients with obstructive azoospermia were treated at the Minia University Hospital using a new microsurgical bilateral epididymovasostomy technique. The technique involved the opening of a small window in the tunica of the epididymis, making an opening in the underneath epididymal tubule and keeping it open by fixing the edges of the epididymal opening to the edge of the epididymal tunica with four 10/0 nylon sutures. The abdominal cut end of the vas deferens was then anastomosed to the epididymal opening by suturing the epididymal tubule, fixed to its tunica in one layer, to the full thickness vas deferens. The main outcome measure was finding sperm in the ejaculate.
Sperm was found in the ejaculate in six out of nine patients after our new, one-layer, epididymovasostomy technique. Mean ± sd operating time was 176 ± 23 min.
This new, one-layer, epididymovasostomy technique provides a simple alternative method of epididymovasostomy, with reasonable outcomes. More cases and follow-up are needed to make meaningful comparisons with conventional epididymovasostomy.
描述并评估一种新的附睾输精管吻合术技术的效果。
在米尼亚大学医院，采用一种新的双侧显微附睾输精管吻合术技术对9例梗阻性无精子症患者进行治疗。该技术包括在附睾白膜上开一个小窗口，在其下方的附睾小管上开口，并通过用4根10/0尼龙缝线将附睾开口边缘固定于附睾白膜边缘来保持开口开放。然后将输精管的腹部断端与附睾开口进行吻合，方法是将固定于白膜的附睾小管与输精管全层缝合在一起。主要观察指标是在射精液中发现精子。
采用我们新的单层附睾输精管吻合术技术后，9例患者中有6例在射精液中发现了精子。平均手术时间为176±23分钟（均值±标准差）。
这种新的单层附睾输精管吻合术技术提供了一种简单的附睾输精管吻合替代方法，效果合理。需要更多病例和随访来与传统附睾输精管吻合术进行有意义的比较。
