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Abstract

Volume 25, Issue 2 (March 2023) 25, 277–280; 10.4103/aja202238

The effect of BMI and age on the outcomes of microsurgical vasoepididymostomy: a retrospective analysis of 181 patients operated by a single surgeon

Shou-Yang Wang1,2, Yang-Yi Fang1,2, Hai-Tao Zhang1,2, Yu Tian1, Vera Yeung Chung3, Yin-Chu Cheng4, Kai Hong1,2, Hui Jiang1,2

1 Department of Urology, Peking University Third Hospital, Beijing 100191, China
2 Department of Reproductive Medicine, Peking University Third Hospital, Beijing 100191, China
3 Department of Urology, Gleneagles Hospital Hong Kong, Hong Kong, China
4 Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China

Correspondence: Dr. K Hong (kenhong99@bjmu.edu.cn) or Dr. H Jiang (jianghui55@163.com)

Received: 16 December 2021; Accepted: 12 May 2022; published online: 24 June 2022

Abstract

To design a treatment plan for patients with epididymal obstruction, we explored the potential impact of factors such as body mass index (BMI) and age on the surgical outcomes of vasoepididymostomy (VE). In this retrospective study, 181 patients diagnosed with obstructive azoospermia (OA) due to epididymal obstruction between September 2014 and September 2017 were reviewed. All patients underwent single-armed microsurgical intussusception VEs with longitudinal two-suture placement performed by a single surgeon (KH) in a single hospital (Peking University Third Hospital, Beijing, China). Six factors that could possibly influence the patency rates were analyzed, including BMI, age, mode of anastomosis, site of anastomosis, and sperm motility and quantity in the intraoperative epididymal fluid. Single-factor outcome analysis was performed via Chi-square test and multivariable analysis was performed using logistic regression. A total of 159 (87.8%, 159/181) patients were followed up. The follow-up time (mean ± standard deviation [s.d.]) was 27.7 ± 9.3 months, ranging from 12 months to 48 months. The overall patency rate was 73.0% (116/159). The multivariable analysis revealed that BMI and age significantly influenced the patency rate (P = 0.008 and 0.028, respectively). Younger age (≤28 years; odds ratio [OR] = 3.531, 95% confidence interval [95% CI]: 1.397–8.924) and lower BMI score (<26.0 kg m−2; OR = 2.352, 95% CI: 1.095–5.054) appeared to be associated with a higher patency rate. BMI and age were independent factors affecting the outcomes of microsurgical VEs depending on surgical expertise and the use of advanced technology.

Keywords: epididymal obstruction; obstructive azoospermia; patency rate; vasoepididymostomy

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.