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输精管再通术是解除精道梗阻,恢复生育力的重要措施。早年,人们曾尝试输精管睾丸吻合,输精管附睾吻合和输精管～输精管吻合,都取得了一定成功。显微外科技术的应用,进一步提高了输精管再通术的效果,术后复精率几乎达到100%。但输精管再通术的手术方法莫衷一是,术后复孕率的提高也有待进一步探讨。本文复习近年文献,就输精管梗阻后的病理变化,输精管再通手术方法与手术方法的选择等方面综述如下。【输精管梗阻后的病理变化】:输精管梗阻后的病理变化,可因梗阻部位和原因不同而有差别。一般说来,机械性梗阻的结果要比病理性或先天性梗阻单纯,近睾段梗阻的改变要比远睾段梗阻复杂。在精道梗阻中,输精管绝育术是精道中段机械性梗阻最常见的原因。输精管阻断后大致有以下几种病理变化。①近睾段输精管和附睾管管腔扩张:输精管梗阻后睾丸生精功能并未停止,每天仍有精子生成和睾网液分泌;附睾除了促进精子成熟外,还具有吸收睾网液的
Vaso-recanalization is an important measure to relieve obstruction and restore fertility. Early years, people have tried vas deferens testes anastomosis, vas deferens anastomosis and vas deferens anastomosis, have achieved some success. The application of microsurgery technology to further improve the effect of vas deferens recanalization, postoperative reconciliation rate of almost 100%. However, the vas deferens recanalization surgery incomprehensible, postoperative pregnancy rate increase also needs to be further explored. This review of the literature in recent years, the pathological changes after vasectomy obstruction, vas deferens recanalization surgery and surgical methods of choice are summarized below. Pathological changes after vas deferens obstruction: pathological changes after vas deferens obstruction, may be due to different parts of the obstruction and the reasons for the difference. In general, the results of mechanical obstruction than pathological or congenital simple obstruction, changes in proximal testicular obstruction than the distal testis obstruction complex. In obstructive tract obstruction, vas deferens sterilization is the most common cause of mechanical obstruction in the middle of fine tract. Vas deferens generally have the following pathological changes after the block. ① proximal testis vas deferens and epididymal lumen dilatation: vas deferens sperm function after testicular sperm function did not stop every day there is still sperm production and secretion of testis fluid; epididymis in addition to promoting sperm maturation, but also with the absorption of testis fluid