Belker A M, Jimenez-Cruz D J, Kelami A, Wagenknecht L V
J Urol. 1986 Aug;136(2):408-9. doi: 10.1016/s0022-5347(17)44885-3.
After vasectomy reversal by vasovasostomy or vasoepididymostomy motile sperm appear commonly in the semen even when only nonmotile sperm are present in the intraoperative vasal or epididymal fluid. We studied patients with bilateral congenitally absent vasa deferentia to see if relief of obstruction by implantation of an alloplastic spermatocele also benefits sperm motility in such patients. A total of 130 alloplastic spermatoceles was implanted in 91 patients. Of 21 patients with only nonmotile sperm in the epididymal fluid intraoperatively only 1 had motile sperm in the postoperative aspirates from the alloplastic spermatocele. The quality of sperm motility in the intraoperative epididymal fluid was predictive of the quality of sperm motility in the postoperative aspirates. Conception postoperatively did not occur whenever less than 20 per cent of the intraoperative epididymal sperm was motile. Thus, poor or absent sperm motility in the epididymal fluid during planned alloplastic spermatocele implantation predicts a poor postoperative result and, therefore, contraindicates implantation of the prosthesis. Pregnancy, which occurred postoperatively in 7 of 91 wives, ended in spontaneous abortion in 3 and progressed to full-term delivery in 4.
在通过输精管吻合术或输精管附睾吻合术进行输精管复通术后，即使术中输精管或附睾液中仅存在无活力精子，精液中通常也会出现有活力精子。我们研究了双侧先天性输精管缺如的患者，以观察植入异体精子囊肿解除梗阻是否也能改善这类患者的精子活力。共对91例患者植入了130个异体精子囊肿。术中附睾液中仅有无活力精子的21例患者中，术后从异体精子囊肿吸出物中仅有1例有活力精子。术中附睾液中精子活力的质量可预测术后吸出物中精子活力的质量。当术中附睾精子活力低于20%时，术后未发生受孕。因此，在计划植入异体精子囊肿时，附睾液中精子活力差或无活力预示术后结果不佳，因此不适合植入假体。91例患者的妻子中有7例术后怀孕，其中3例自然流产，4例足月分娩。
