摘要
Microsurgical longitudinal intussusception vasoepididymostomy （LIVE） has been widely used to treat epididymal obstructive azoospermia since 2004. Although the deferential vasculature plays an important role in supplying blood to the testis and epididymis, little attention has been paid to the potential benefits of sparing the deferential vessels during the anastomosis in LIVE. This study aimed to evaluate the efficacy and safety of deferential vessel-sparing LIVE in humans. From December 2013 to December 2015, 69 azoospermic men with epididymal obstruction due to a genital infection, trauma, or idiopathic factors underwent deferential vessel-sparing LIVE in the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. The outcomes of these patients were analyzed retrospectively. The mean age was 31.1 years for men and 28.3 years for their partners. Fifty-nine （85.5%, 59/69） men were followed up after surgery for approximately 16 months. Patency was noted and confirmed by semen analysis （〉10 000 sperm/ml） in 83.1% （49159） of men. The natural pregnancy rate was 40.7% （24/59） by the end of the study, with 87.5% （21124） of these natural pregnancies achieved within 12 months after surgery. No severe adverse events or complications were observed. In this study, we present a novel technique for sparing the deferential vessels during LIVE. The preliminary outcomes show this technique to be safe with favorable patency and pregnancy rates.
Microsurgical longitudinal intussusception vasoepididymostomy （LIVE） has been widely used to treat epididymal obstructive azoospermia since 2004. Although the deferential vasculature plays an important role in supplying blood to the testis and epididymis, little attention has been paid to the potential benefits of sparing the deferential vessels during the anastomosis in LIVE. This study aimed to evaluate the efficacy and safety of deferential vessel-sparing LIVE in humans. From December 2013 to December 2015, 69 azoospermic men with epididymal obstruction due to a genital infection, trauma, or idiopathic factors underwent deferential vessel-sparing LIVE in the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. The outcomes of these patients were analyzed retrospectively. The mean age was 31.1 years for men and 28.3 years for their partners. Fifty-nine （85.5%, 59/69） men were followed up after surgery for approximately 16 months. Patency was noted and confirmed by semen analysis （〉10 000 sperm/ml） in 83.1% （49159） of men. The natural pregnancy rate was 40.7% （24/59） by the end of the study, with 87.5% （21124） of these natural pregnancies achieved within 12 months after surgery. No severe adverse events or complications were observed. In this study, we present a novel technique for sparing the deferential vessels during LIVE. The preliminary outcomes show this technique to be safe with favorable patency and pregnancy rates.
作者
Kun-Long Lyu
]in-Tao Zhuang
Philip S Li
Yong Gao
Liang Zhao
Ya-Dong Zhang
Ming-Kuan Zhou
jing-Wei Yu
Xin Feng
Xiang-Zhou Sun
Chun-Hua Deng
Xiang-An Tu
Kun-Long Lyu;Jin-Tao Zhuang;Philip S Li;Yong Gao;Liang Zhao;Ya-Dong Zhang;Ming-Kuan Zhou;Jing-Wei Yu;Xin Feng;Xiang-Zhou Sun;Chun-Hua Deng;Xiang-An Tu(：Department of Urology and Andrology,The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510000,China;Department of Urology and Andrology,The First Affiliated Hospital of Zhengzheu University,Zhengzhou 450000,China;Center for Male Reproductive Medicine and Microsurgery,Department of Urology,Weill Cornell Medicine of Cornell University,New York,NY 10065,USA;Center for Reproductive Medicine,Guangdong Provincial Key Laboratory of Reproductive Medicine,The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510000,China.)
基金
This work was supported by grants from the National Natural Science Foundation of China （No. 81172432, 81302223, 81671449, and 81471449）, the Guangdong Province Natural Science Foundation （No. 2015A030313141 and 2015A030313013）, the Scientific and Technical Project of Guangdong Province （No. 2016B030230001, 2013B051000021, 2016A040403113, 2016A020214004, and 2016A020218007）, and the Scientific and Technical Project of Guangzhou city （No. 2013J4500010 and 201604020189）.
