Patency Rates of Microsurgical Vasoepididymostomy for Patients With Idiopathic Obstructive Azoospermia: A Prospective Analysis of Factors Associated With Patency—Single-center Experience

Abstract

To evaluate the factors that might be associated with the patency rates of microsurgical vasoepididymostomy for idiopathic obstructive azoospermia. From January 2009 to July 2010, we evaluated the data from 73 men with obstructive azoospermia who had undergone longitudinal intussusception vasoepididymostomy. The mean age was 30.9±4.9 years (range 22-48). The outcomes were analyzed by the pre- or intraoperative clinical findings: epididymal fullness, unilateral or bilateral procedure, site of anastomosis, and epididymal fluid findings. The mean follow-up was 13.5±5.3 months (range 4-22) for 53 patients (72.6%). The overall patency rate was 71.7% (n=38). The patency rate was 87.2%, 80.7%, 78.8%, 100%, and 83.7% for epididymal fullness, bilateral surgery, corpus anastomosis, caudal anastomosis, and flowing fluid with motile sperm, respectively. The natural pregnancy rate was 33.3% at a mean of 9.9±4.2 months of follow-up. Longitudinal intussusception vasopididymostomy can provide a good patency rate, with success associated with epididymal fullness, bilateral surgery, distal epididymal anastomosis, and flowing fluid with motile sperm.