Silber S J
Fertil Steril. 1980 Aug;34(2):149-53.
We previously reported a microsurgical technique for bypassing epididymal obstruction by performing a specific microanastomosis to the epididymal tubule. When obstruction was near the head of the epididymis, spermatozoal motility was always poor (0 to 1%) even though the numerical count was high. There are now over 1 1/2 years of follow-up on the first five patients who had a vasoepididymostomy performed in the proximal region (head) of the epididymis. None of these patients had more than 0 to 1% spermatozoal motility postoperatively despite counts of more than 50 million sperm/ml. However, within 1 1/2 to 2 years the spermatozoa of these patients eventually developed normal motility. This study verifies that in humans spermatozoa derived from the head of the epididymis are at first not capable of motility. However, after 1 or 2 years, these spermatozoa eventually recover normal motility. This unexpected finding sheds new light on epididymal physiology and offers some hope for men with proximal epididymal obstruction.
我们之前报道过一种显微外科技术，即通过对附睾管进行特定的显微吻合术来绕过附睾梗阻。当梗阻靠近附睾头部时，即使精子数量较多，精子活力也总是很差（0%至1%）。目前，对首批5例在附睾近端（头部）进行输精管附睾吻合术的患者进行了超过一年半的随访。尽管这些患者术后精子计数超过5000万/ml，但术后精子活力均不超过0%至1%。然而，在一年半到两年内，这些患者的精子最终恢复了正常活力。这项研究证实，在人类中，源自附睾头部的精子起初没有运动能力。然而，1或2年后，这些精子最终恢复了正常活力。这一意外发现为附睾生理学提供了新的线索，并为患有近端附睾梗阻的男性带来了一些希望。
