title: [Microsurgical treatment of obstructive azoospermia: a report of 76 cases].
abstract: OBJECTIVE
  To investigate the clinical effect of microsurgical vasoepididymostomy and/or vasovasostomy in the treatment of obstructive azoospermia.
  
  
  METHODS
  This study included 76 patients with obstructive azoospermia, 53 treated by bilateral vasoepididymostomy (8 involving the epididymal head, 18 involving the epididymal body, 5 involving the epididymal tail, and 22 involving the epididymal head, body and tail), 14 by unilateral vasoepididymostomy, and the other 9 by unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis). We followed up the patients for 2 to 16 months for the patency rate, routine semen parameters, and pregnancy outcomes.
  
  
  RESULTS
  The success rate of bilateral vasoepididymostomy, unilateral vasoepididymostomy, and unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis) were 62.26% (33/53), 35.71% (5/14), and 77.78% (7/9), respectively. The average sperm concentrations in the three groups of patients were (27.9 +/- 5.74), (11.8 +/- 8.33), and (19.9 +/- 7.53) x 10(6)/ml, the average total sperm counts were (65.6 +/- 13.71), (28.0 +/- 15.86), and (69.2 +/- 28.59) x 10(6), and the mean rates of progressively motile sperm were (22.3 +/- 3.18), (11.0 +/- 9.77), and (15.8 +/- 5.05)%, respectively. The success rates of bilateral vasoepididymostomy that involved the epididymal head, body, tail, and all the three parts were 62.5, 72.22, 60, and 54.55%, respectively. Natural pregnancy was achieved in 8 (10.53%) of the total number of cases.
  
  
  CONCLUSIONS
  Microsurgery is effective for the treatment obstructive azoospermia. Unilateral vasoepididymostomy + unilateral vasovasostomy is superior to the other procedures, followed by bilateral vasoepididymostomy. Bilateral vasoepididymostomy involving the epididymal body may achieve a slightly better effect than that involving the other epididymal parts.
authors.forename: Feng-bin
authors.initials: FB
authors.lastname: Zhang
authors.forename: Zhong-yan
authors.initials: ZY
authors.lastname: Liang
authors.forename: Le-jun
authors.initials: LJ
authors.lastname: Li
authors.forename: Jing-ping
authors.initials: JP
authors.lastname: Li
authors.forename: Jing-gen
authors.initials: JG
authors.lastname: Wu
authors.forename: Fan
authors.initials: F
authors.lastname: Jin
authors.forename: Yong-hong
authors.initials: YH
authors.lastname: Tian
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D053713:Azoospermia / Q000209:etiology / Q000601:surgery*; D004822:Epididymis / Q000601:surgery*; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000601:surgery; D008297:Male; D008866:Microsurgery; D011247:Pregnancy; D018873:Pregnancy Rate; D013076:Sperm Count; D016896:Treatment Outcome; D014649:Vas Deferens / Q000601:surgery*; D014669:Vasovasostomy / Q000379:methods*