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Li P, Liu N, Zhi E, Yao C, Chen H, Tian R, Huang Y, Zhao L, Yang C, Zhao J, Shi C, Liu M, Wang B, Chen H, Li Z, Xia S. Vasal vessel-sparing microsurgical single-armed vasoepididymostomy to epididymal obstructive azoospermia: A retrospective control study. Andrologia 2021; 53:e14133. [PMID: 34260106 DOI: 10.1111/and.14133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 11/29/2022] Open
Abstract
This study aimed to evaluate the efficacy and safety of vasal vessel-sparing modified single-armed 2-suture longitudinal intussusception vasoepididymostomy (SA-LIVE) to epididymal obstructive azoospermia patients. Forty consecutive epididymal obstructive azoospermia cases, who underwent microsurgical vasoepididymostomy in Shanghai General Hospital from January 2019 to October 2019, were included in this study. Twenty cases underwent SA-LIVE (group A), and 20 cases underwent vasal vessel-sparing SA-LIVE (group B). Until March 2021, the mean follow-up period was 16.9 ± 4.1 (12-23) months. The overall patency rate was 82.5%, and 80% and 85% for group A and group B respectively. The mean time to achieve patency was 4.11 ± 2.74 months. The overall natural pregnancy rate was 51.5%(17/33) at the mean follow-up of 16.9 months. The natural pregnancy rate was 50.0% for group A and 52.9% for group B (p > .05). At the time of 6 months post-operation, the patency rate was 70% for group A and 80% for group B (p = .465); the natural pregnancy rate was 0% for group A and 31.3% for group B (p = .022). Vasal vessel-sparing SA-LIVE is safe and effective to achieve favourable patency and pregnancy rates. Preserving vasal vessel would improve natural pregnancy rate at a very early stage.
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Affiliation(s)
- Peng Li
- Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Nachuan Liu
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Erlei Zhi
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Chencheng Yao
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Huixing Chen
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ruhui Tian
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yuhua Huang
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Liangyu Zhao
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Chao Yang
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jingpeng Zhao
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Chenkun Shi
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ming Liu
- Department of Urology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Bo Wang
- Department of Urology, The Second Hospital in Weinan, Weinan, China
| | - Huirong Chen
- Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng Li
- Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Shujie Xia
- Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
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Lyu KL, Zhuang JT, Li PS, Gao Y, Zhao L, Zhang YD, Zhou MK, Yu JW, Feng X, Sun XZ, Deng CH, Tu XA. A novel experience of deferential vessel-sparing microsurgical vasoepididymostomy. Asian J Androl 2019; 20:576-580. [PMID: 29974884 PMCID: PMC6219301 DOI: 10.4103/aja.aja_46_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
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% (49/59) of men. The natural pregnancy rate was 40.7% (24/59) by the end of the study, with 87.5% (21/24) 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.
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Affiliation(s)
- Kun-Long Lyu
- 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 Zhengzhou University, Zhengzhou 450000, China
| | - Jin-Tao Zhuang
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Philip S Li
- Center for Male Reproductive Medicine and Microsurgery, Department of Urology, Weill Cornell Medicine of Cornell University, New York, NY 10065, USA
| | - Yong Gao
- Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Liang Zhao
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Ya-Dong Zhang
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Ming-Kuan Zhou
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Jing-Wei Yu
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Xin Feng
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Xiang-Zhou Sun
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Chun-Hua Deng
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
| | - Xiang-An Tu
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, China
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