Department of Andrology and Sexual Medicine, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
Nursing Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
Asian J Androl. 2024 Nov 1;26(6):640-644. doi: 10.4103/aja202462. Epub 2024 Aug 27.
Although microsurgical vasoepididymostomy (MVE) is an effective treatment for epididymal obstructive azoospermia, some patients may experience delayed patency or suboptimal semen parameters after patency. However, research into patency time, semen quality postpatency, and associated influencing factors remains limited. This study aimed to address these issues by evaluating 181 patients who underwent at least one-sided MVE employing asingle-armed longitudinal intussusception vasoepididymostomy technique, with a follow-up period of over 12 months for 150 patients. The overall patency rate was 75.3%, with 86.0% of patients achieving patency within 6 months following MVE. Unexpectedly, factors such as age, history of epididymitis, duration of surgery, side of anastomosis, sperm motility in epididymal fluid, and the site of anastomosis showed no correlation with patency time. Nonetheless, our univariate and multivariate linear regression analysis indicated that only the site of anastomosis was positively correlated with and could independently predict postoperative total motile sperm count. Therefore, the site of anastomosis might serve as a predictor for optimal postoperative semen quality following the MVE procedure.
虽然显微外科附睾吻合术（MVE）是治疗附睾梗阻性无精子症的有效方法，但一些患者在通畅后可能会出现通畅时间延迟或精液参数不理想的情况。然而，关于通畅时间、通畅后精液质量以及相关影响因素的研究仍然有限。本研究通过评估 181 例至少一侧采用单臂纵向套入式附睾吻合术技术的患者，其中 150 例患者的随访时间超过 12 个月，旨在解决这些问题。总的通畅率为 75.3%，MVE 后 6 个月内有 86.0%的患者实现了通畅。出乎意料的是，年龄、附睾炎病史、手术持续时间、吻合侧、附睾液中精子活动力和吻合部位等因素与通畅时间无相关性。然而，我们的单因素和多因素线性回归分析表明，只有吻合部位与术后总活动精子数呈正相关，并可独立预测术后总活动精子数。因此，吻合部位可能是 MVE 术后获得最佳精液质量的预测指标。
