Clinical Application Of Microsurgical Vasoepididymostomy In Treatment Of Obstructive Azoospermia

Objective: To discuss the methods of qualitative diagnosis and localization of obstructive azoospermia,surgical techniques,evaluating the clinical effect in the treatment of obstructive azoospermia in microsurgical vasoepididymostomy.Method: Retrospect and analyze the clinical data of 52 patients with obstructive azoospermia at General Hospital of Ningxia Medical University from July 2014 to August 2017,including medical history,physical examination,hormones,scrotal ultrasound,semen analysis,and operation method.Result: Among the 52 patients enrolled,patients with epididymal obstruction was the most common,accounting for 50%(26/52).After vasoepididymostomy,the patency rate was 50%(13/26)and the spouse natural pregnancy rate was 15.38%(4/26).Among them,the unilateral surgery postoperative patency rate was 42.86%(3/7),bilateral surgery postoperative patency rate was 52.63%(10/19),showed no significant difference(P> 0.05).The other patients had 11.54% of ejaculation obstruction,15.38% of vas deferens obstruction,3.85% of intra-testicular obstruction,and 19.23% of non-obstructive azoospermia.Luteinizing hormone,follicle stimulating hormone,testosterone,prolactin,and estradiol in obstructive azoospermia patients and misdiagnosed non-obstructive azoospermia patients showed no significant difference(P> 0.05),but differences of progesterone was significant(P ≤0.05).The scrotal ultrasound positive rate of the patients with epididymal obstruction(53.85%)and the patients with other parts of obstruction(26.92%)showed significant difference(P≤0.05).Postoperative patients’ sperm volume and sperm concentration had no significant difference(P> 0.05)than the normal adult men,progressive sperm rate difference was significant(P <0.01).Conclusion: The qualitative diagnosis and localization of obstructive azoospermia should be multiply diagnosed by combining history,physical examination,and a number of docimasia;vasoepididymostomy has satisfactory results for treatment of epididymal obstruction;operation methods and techniques determine the results and postoperative complications;patients has poor sperm motility after surgery,they can be treated by combining with medical treatment.