Effect of preoperative epididymal puncture on microsurgical reconstruction of reproductive tract in patients with obstructive azoospermia
Objective To investigate whether preoperative epididymal puncture affects the surgical efficacy of microsurgical reconstruction of reproductive tract in patients with obstructive azoospermia.Methods Clinical data of 86 patients who received microsurgical vasoepididymostomy in Nanjing Drum Tower Hospital from June 2020 to June 2022 were retrospectively analyzed.According to whether preoperative epididymal puncture was performed,they were divided into the puncture group(n=37)and the non-puncture group(n=49),and the surgical situation,postoperative seminal tract patency condition,and spouse pregnancy condition were compared and analyzed.Results Among 37 patients in puncture group,22 patients had patency(59.46％).Among 49 patients in non-puncture group,39 patients had patency(79.59％).The patency rate of patients in puncture group was lower than that in non-puncture group,and the difference was statistically significant(P＜0.05).There were no significant differences in age and body mass index between the two groups(P＞0.05).The average surgical time in puncture group was longer than that in non-puncture group,the bilateral anastomosis rate in puncture group was lower than that in non-puncture group,the head anastomosis rate in puncture group was higher than that of non-puncture group,with the statistically significant differences(P＜0.05).Among the 22 patients with patency in the puncture group,spouses of 5 had spontaneous pregnancy(22.73％),while in the non-puncture group,spouses of 11 had spontaneous pregnancy(28.21％).There was no significant difference in the spontaneous pregnancy rate between the two groups(P＞0.05).Conclusions Microsurgical reconstruction can provide better reproductive choices for some obstructive azoospermia patients.Preoperative epididymal puncture may reduce the patency rate of reproductive tract after operation,which needs careful consideration.
万方数据
维普
