AB089. The treatment of the obstructive azoospermia by microsurgical vasoepididymostomy: a 42 cases report

OBJECTIVE: To analyze the patency and natural pregnancy rate after the microsurgical vasoepididymostomy, the influence of the anastomosis site on the patency rate in the patients of obstructive azoospermia. METHODS: A total of 42 cases of obstructive azoospermia underwent microsurgical vasoepididymostomy in our hospital from March 2012 to March 2014. Their clinical information, especially the finding and the processed method in the operation, the results in the, postoperative follow-up were collected, the patency and natural pregnancy rate were statistically analyzed. RESULTS: The mean age of the 42 cases was 34.6 years (range from 20 to 58 years). Thirty-nine cases underwent bilateral anastomosis, three cases underwent unilateral anastomosis. The patients of the anastomosis on caput, corputs and caudal levels were 9, 8, and 25 cases respectively. The average follow-up period was 9.57 months (range from 3 to 24 months). The patency rate was 73.8% (31/42) and the natural pregnancy rate was 23.8% (10/42). The sperm density was (0–42)×10(6)/mL [(13.97±13.07)×10(6)/mL]. The sperm motility rate was 0–57%. The patency rates in the patients with bilateral and unilateral anastomosis were 76.9% and 33.3%, respectively. The natural pregnancy rates in the patients with bilateral and unilateral anastomosis were 28.2%, 0, respectively. The patency in the patients with caput, corputs, and caudal anastomosis was 80%, 75%, 55.6%, respectively. CONCLUSIONS: Microsurgical vasoepididymostomy is an effective method for the treatment of obstructive azoospermia caused by epididymis obstruction. To be able to do the bilateral anastomosis and the anastomosis on caudal level of epididymis may have higher patency rate and natural pregnancy rate.