Analysis The Treatment Effects And Clinical Effective After Microsurgical Epididymovasostomy

Objective: To investigate the treatment effects and its influencing factors after the microsurgical epididymovasostomy(MVE).Methods: we retrospectively studied the clinical data of 62 patients with obstructive azoospermia of epididymis undergoing microsurgical epididymovasostomy from May 2015 to October 2017 in our hospital.The recovery of sperm and the fertility status of the patients’ wives were observed to evaluate the influencing factors of treatment effects with postoperative follow-up.Results: Of all the patients,60 were followed up and the mean follow-up period was 15.3±6.87 months.The average operative time was 250± 46.17 minutes,the average hospitalization time was 6.5±1.88 days and expenses was 13910±1890.49 RMB.Sperm was present in the ejaculate in 41 patients postoperatively.The overall patency rate was 68.3%.Sperm was found in 18 cases within 3 mouths,in 15 cases within 4-6 mouths,in 7 cases within 7-12 mouths,and 1 cases after 12 mouths.The patency rate of motile sperm with epididymal fluid continuing flowage was 76.9%(30/39)and of immotile sperm was 52.4%(11/21).The patency rate of the patients with bilateral surgery and unilateral surgery was 77.8 %(35/45)and 40.0 %(6/15),respectively.The crossed vasovasostomy was successfully performed in 2 cases,and 1 case repored patency.The patent rate of caput,corpus and caudal anastomosis was 58.3%(7/13),73.6%(28/38)and 66.6%(6/9),respectively.On the other hand,16 patients reported spontaneous pregnancy.The rate of the spontaneous pregnancy was 39.0%(16/41).Moreover,they was all bilateral surgery.9 patients chose assisted reproduction after MVE,and 3 spouses were clinically pregnancy.Conclusion: The clinical effects of the MVE was influenced by the following factors: the number and site of the anastomosis,the skilled microsurgical technique.In our hospital,clinical curative effects after the microsurgical epididymovasostomy was favorable.Further it has more advantages to patients in the safety,operation time,hospitalization time and expenses.Clinically,we need get the appropriate means of treatment under the patient’s clinical effects,spouse’s age,health status,and economic conditions,with consideration of methodology and cost-effective for infertile couples.