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Updated: Apr 29, 2026
Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
Published on: May 27, 2022
[Diagnosis and treatment of epididymal obstructive azoospermia by microsurgery]
Xue-De Li1, Qing-Xin He, Sheng-Hai Fan
1Department of Andrology, No. 181 Hospital of Chinese People's Liberation Army, Guilin, Guangxi 541002, China. llql@sina.com
Objective:
To investigate the diagnosis and treatment of epididymal obstructive azoospermia (OA) by microsurgery.
Methods:
We performed surgical scrotal exploration for 57 cases of OA whose obstruction was suspected to be in the epididymis. Those confirmed to be epididymal OA cases and with motile sperm in the epididymis underwent longitudinal-2-suture intussusceptive vasoepididymostomy (LIVES). And for those with sperm in the epididymal head only or with bilateral obstruction or absence of the vas deferens in the distal epididymis, the sperm were collected and subjected to cryopreservation for intracytoplasmic sperm injection (ICSI). After surgery, the patients were followed up for observation of the semen parameters and the rate of pregnancy.
Results:
Of the total number of patients, 53 (92.9%) were diagnosed with epididymal OA by scrotal exploration, 47 (82.5%) underwent microsurgery, and the other 10 (17.5%) received sperm cryopreservation. At 1 to 18 months after surgery, motile sperm were found in the ejaculate in 46.8% of the cases (22/47), natural pregnancy in 10.6% (5/47), and ICSI pregnancy in 18.5% (6/32).
Conclusion:
With the development of microsurgery, non-invasive means should be the first choice for the diagnosis of OA. And surgical exploration can be employed to determine the location of obstruction and the option for treatment.
