Patency rates of microsurgical vasoepididymostomy for patients with idiopathic obstructive azoospermia: a prospective analysis of factors associated with patency--single-center experience

Abstract

Objective: To evaluate the factors that might be associated with the patency rates of microsurgical vasoepididymostomy for idiopathic obstructive azoospermia.

Methods: From January 2009 to July 2010, we evaluated the data from 73 men with obstructive azoospermia who had undergone longitudinal intussusception vasoepididymostomy. The mean age was 30.9±4.9 years (range 22-48). The outcomes were analyzed by the pre- or intraoperative clinical findings: epididymal fullness, unilateral or bilateral procedure, site of anastomosis, and epididymal fluid findings.

Results: The mean follow-up was 13.5±5.3 months (range 4-22) for 53 patients (72.6%). The overall patency rate was 71.7% (n=38). The patency rate was 87.2%, 80.7%, 78.8%, 100%, and 83.7% for epididymal fullness, bilateral surgery, corpus anastomosis, caudal anastomosis, and flowing fluid with motile sperm, respectively. The natural pregnancy rate was 33.3% at a mean of 9.9±4.2 months of follow-up.

Conclusion: Longitudinal intussusception vasopididymostomy can provide a good patency rate, with success associated with epididymal fullness, bilateral surgery, distal epididymal anastomosis, and flowing fluid with motile sperm.