【摘 要】
：
Objective: Microsurgical reconstruction is recommended for obstructions in the vas deferens and epididymis.However,intracytoplasmic sperm injection(ICSI)is the preferred therapy and microsurgical vaso
【机 构】
：
Andrology Center,Peking University First Hospital,Beijing 100034,China
【出 处】
：
华夏医学论坛·泌尿生殖2015暨亚太性医学年会2015
论文部分内容阅读
Objective: Microsurgical reconstruction is recommended for obstructions in the vas deferens and epididymis.However,intracytoplasmic sperm injection(ICSI)is the preferred therapy and microsurgical vasoepididymostomy(MVE)may be neglected for patients with epididymal obstruction.Fertility outcomes from large sample are absent.In this study we aimed to investigate the pregnancy and live birth rates of MVE for 241 patients with epididymal obstruction and identify the possible predictive factors.Methods: From January 2011 to December 2013,241 male patients with obstructive azoospermia underwent MVE in our center.Semen was analyzed 3 months postoperatively.The patency,pregnancy and live birth rates were evaluated.The preoperative and intraoperative data were compared between patency and non-patency groups to identify the factors affecting the patency rate.Univariate and multivariate analyses with Cox regression models were performed to identify predictors of spontaneous pregnancy.Results: One hundred and ninety-eight(82.2%)patients were followed up and their data analyzed.The mean age of men and female partners were 31.0±5.8 and 28.4±4.4 years,respectively.Sperm was present in the ejaculate of 151 patients(76.3%)at a mean of 3.8 months postoperatively.Patients with two sides of anastomosis and distant anastomosis had higher patency rates.Eighty-one patients(40.9%)reported spontaneous pregnancy and a total of 73 newborns were successfully delivered.The overall live birth rate was 34.8%.Univariate and multivariate analyses revealed male age,sperm concentration and forward motility were independent predictive factors for natural pregnancy.Conclusions: The success rate is related to side and location of anastomosis.The sperm concentration and forward motility may predict the natural pregnancy.Therefore,microsurgical reconstruction is an effective treatment and should be the first choice for epididymal obstruction.
其他文献
Objective: To investigate the efficacy and safety of laparoscopic ileal bladder augmentation in treating patients with low compliant bladder dysfunction.Methods: From June 2011 to December 2013,22 pat
Objective: Flexible ureteroscopy is rapidly becoming a first line therapy for many patients with renal and ureteral calculi.Currently the medical infusion devices cannot monitor the renal pelvic press
Objective: To evaluate the efficacy and safety of standard percutaneous nephrolithotomy(PCNL)for patients with deformity of spine.Methods: Between August 2003 and May 2012,76 patients of upper urinary
Objective: For the patients with pelvic floor dysfunction(PFD)associated with stress urinary incontinence(SUI),we used the polypropylene mesh for pelvic floor repair via transvaginal and the laparosco
Background and Objective: Management of renal cell carcinoma(RCC)with tumor thrombus extending to the renal vein and inferior vena cava(IVC)is challenging.The aim of this study was to evaluate the ben
Objective: We summarized the successful experiences of totally laparoscopic tumorectomy for a large adrenal neoplasm with two failed operations.Methods: The retroperitoneal laparoscopic tumorectomy wa
Objective: To determine the detailed association between overactive bladder(OAB)and peri-menopause syndrome(PMpS)in Chinese female physicians of peri-menopausal age.Methods: Data for this study were c
Objective: To investigate the changes of secretory function of Sertoli cells and testicular damage in diabetic rats.Methods: Diabetes was induced by intraperitoneal injection of streptozotocin(STZ,55
Objective: Explore the curative effect of obstructive azoospermia by using operation.Methods: Eighteen18 patients treated by TURED operation in CSEA,17 of them need cut-through verumontanum to find th
Objective: To explore the new mechanisms of tamoxifen(TAM)in the treatment for patients with idiopathic oligoasthenospermia—antioxidation.Methods: In a prospective,randomized,controlled clinical trial