Asian Journal of Andrology

¹ Department of Urology, Huangpu Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, China
² Department of Urology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China

Correspondence: Dr XA Tu, (txabs9988@163.com)

* These authors contributed equally to this work.

Received 19 May 2012; Revised 27 June 2012; Accepted 31 July 2012
Advance online publication 8 October 2012

Abstract

This study is to evaluate the effectiveness of a modified single-armed suture technique for microsurgical vasoepididymostomy (VE) in patients with epididymal obstructive azoospermia. From September 2011 to December 2011, microsurgical two-suture longitudinal intussusception VEs were performed using our modified single-armed suture technique in 17 men with epididymal obstructive azoospermia at our hospital. Two of these patients underwent repeated VEs after previous failed VEs, and one patient underwent unilateral VE because of an occlusion of the left abdominal vas deferens. The presence of sperm in the semen sample at 3 months postoperation was used as the preliminary endpoint of this study. Each patient provided at least one semen sample at the 3-month time point, and the patency was assessed by the reappearance of sperm (>104 ml−1) in the semen. The mean operative time for the modified technique was 219 min. Patency was noted in 10 men (58.8%), including one patient who underwent repeated VE. The patient who underwent unilateral anastomosis manifested no sperm postoperatively in his semen. Sperm granulomas were not detected in this cohort. The results of this study demonstrate that our modified technique for microsurgical longitudinal intussusception VE is effective. We believe that it is a practical alternative that may reduce operation time and obviate the suture crossing.

Keywords: epididymis; microsurgery; obstructive azoospermia; single-armed technique; vasoepididymostomy; (VE)