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Abstract

Volume 18, Issue 1 (January 2016) 18, 129–133; 10.4103/1008-682X.159718

Multiple factors affecting surgical outcomes and patency rates in use of single-armed two-suture microsurgical vasoepididymostomy: a single surgeon's experience with 81 patients

Kai Hong, Lian-Ming Zhao, Shi-Xing Xu, Wen-Hao Tang, Jia-Ming Mao, De-Feng Liu, Hui Jiang, Lu-Lin Ma, Jie Qiao

Department of Urology, Peking University Third Hospital, Beijing, China; Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China; Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China; 4Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction; Beijing, China.

Correspondence: Prof. H Jiang

14-Aug-2015

Abstract

Vasoepididymostomy (VE), as the most challenging procedure in microsurgeries, is often carried out with a double‑armed two‑suture
technique. In this study, we evaluated the efficacy and safety of the single‑armed two‑suture VEs on humans and studied the factors
that could possibly affect the patency rates. From July 2012 to July 2013, we reviewed 81 patients with consecutive primary
epididymal obstruction who underwent single‑armed two‑suture longitudinal intussusception microsurgical VEs by a single surgeon,
Kai Hong (KH). At the same time, we analyzed seven factors that possibly related to the patency rates. With the single‑armed
technique, a total of 81 men underwent the microsurgical VEs. Data on 62 patients were completely recorded. 19 patients were
lost to follow‑up. Mean age was 31 years old. Mean follow‑up time was 8.8 (2–17) months. The patency rate was 66.1% (41/62).
Natural pregnancy rate was 34.1% (14/41). Overall pregnancy rate was 22.6% (14/62). No severe surgical complications were
noted. With logistic regression test analysis, there were two factors related to a higher patency rate: anastomosis sites (P = 0.035)
and motile sperm found in the epididymal fluid (P = 0.006). Motile sperm found in the epididymal fluid were associated with a
higher patency rate (OR = 11.80, 95% CI = 1.79, 77.65). The single‑armed two‑suture longitudinal VE technique is feasible for
microsurgical practice. The patency and pregnancy rates are comparable to the doubled‑armed technique. Anastomosis sites and
motile sperm found in the epididymal fluid were the most two important factors related to higher patency.

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