MR 33. Surgical treatment for obstructive epididymal azoospermia

Objective: To evaluate the clinical outcomes of surgical treatment on epididymal obstructive azoospermia (EOA) and the factors affecting clinical results.

Methods: We retrospectively analysed the datas of 51 OA patients who underwent a single layer longitudinal 2-suture intussusception vasoepididymostomy (LIVE) between 2000 and 2007. Data collected included technique, months of followup, postoperative motile sperm count (MSC) per ejaculate and percent of progressive motile sperm (PMS). Patency and pregnancy rates were followed.

Results: With extradural anaesthesia, a total of 51 men underwent scrotal exploration. Bilateral epididymal obstructions were comfirmed in 50, while obstructions at epididymis and contralateral vas deferens in 1. Bilateral and unilateral LIVE were performed in 42 and 6 men, respectively. 44 were followed for more than 6 mounths and 39 for more than 1 year. The overall patency and pregnancy rates were 72.7% and 25.6%, respectively. Moreover, progressive motile sperm (PMS) were more often present in those undergoing LIVE at cauda than at corpus or caput. And pregnancy achieved only in those undergoing LIVE at least at 1 side of cauda epididymis.

Conclusions: Loupe-assisted LIVE, with lower cost and simplified surgical procedure, can achieve optimistic patency outcomes and pregnancy results. Datas of this paper also suggest that the outcomes as LIVE at cauda epididymis are superior to that at corpus or caput.