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Epididymal microsurgery

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https://www.readbyqxmd.com/read/26289398/multiple-factors-affecting-surgical-outcomes-and-patency-rates-in-use-of-single-armed-two-suture-microsurgical-vasoepididymostomy-a-single-surgeon-s-experience-with-81-patients
#1
Kai Hong, Lian-Ming Zhao, Shi-Xing Xu, Wen-Hao Tang, Jia-Ming Mao, De-Feng Liu, Hui Jiang, Lu-Lin Ma, Jie Qiao
Vasoepididymostomy (VE), as the most challenging procedure in microsurgeries, is often carried out with a double-armed two-suture technique. In this study, we evaluated the efficacy and safety of the single-armed two-suture VEs on humans and studied the factors that could possibly affect the patency rates. From July 2012 to July 2013, we reviewed 81 patients with consecutive primary epididymal obstruction who underwent single-armed two-suture longitudinal intussusception microsurgical VEs by a single surgeon, Kai Hong (KH)...
January 2016: Asian Journal of Andrology
https://www.readbyqxmd.com/read/25898556/-microsurgical-treatment-of-obstructive-azoospermia-a-report-of-76-cases
#2
Feng-bin Zhang, Zhong-yan Liang, Le-jun Li, Jing-ping Li, Jing-gen Wu, Fan Jin, Yong-hong Tian
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)...
March 2015: Zhonghua Nan Ke Xue, National Journal of Andrology
https://www.readbyqxmd.com/read/24131808/sperm-analysis-of-the-vas-deferens-fluid-after-a-long-interval-of-unilateral-percutaneous-epididymal-sperm-aspiration-in-vasectomized-patients
#3
Fernando Lorenzini, Eduardo Zanchet, Mariana Lorenzini
OBJECTIVES: Evaluation of the presence of spermatozoa in vas deferens fluid after a long interval of unilateral and homolateral percutaneous epididymal sperm aspiration (PESA) in vasectomized men. When found, the spermatozoa were evaluated including concentration and motility, in order to verify the patency of the epididymal tubules. MATERIALS AND METHODS: Four patients, numbered in a progressive order, from one to four, with 38, 40, 48 and 51 years old and vasectomy interval of 10, 10, 25 and 11 years, respectively, whose wives did not get pregnant using intracytoplasmic sperm injection of sperm obtained by unilateral PESA and decided to try only natural conception, were submitted to intrasurgical sperm analysis of the vas deferens fluid (ISAVDF) during microsurgery for reconstruction of the seminal tract...
September 2013: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/23206732/intracytoplasmic-sperm-injection-with-microsurgically-retrieved-spermatozoa-in-azoospermic-men%C3%A2-infected-with-human-immunodeficiency-virus-1-or-hepatitis-c-virus-the-ep43-azoneco-anrs-study
#4
Marianne Leruez-Ville, Nicolas Thiounn, Catherine Poirot, Odile Launay, Philippe Sogni, Sophie Grabar, Emmanuel Dulioust
OBJECTIVE: To evaluate the viral contamination of sperm obtained after testicular sperm extraction (TESE) and microsurgical epididymal sperm aspiration (MESA) in men with azoospermia and human immunodeficiency virus (HIV) or hepatitis C virus infection. DESIGN: Prospective study. SETTING: Fertility clinic, and reproductive technology and virology laboratories. PATIENT(S): Six men with azoospermia: two HIV-1 infected with undetectable blood viral load and four HCV infected with detectable blood viral load...
March 1, 2013: Fertility and Sterility
https://www.readbyqxmd.com/read/23160266/the-evolution-and-refinement-of-vasoepididymostomy-techniques
#5
REVIEW
Peter T Chan
Obstructive azoospermia secondary to epididymal obstruction can be corrected by microsurgical reconstruction with vasoepididymostomy (VE). Although alternative management such as epididymal or testicular sperm aspiration in conjunction with intracytoplasmic sperm injection is feasible, various studies have established the superior cost-effectiveness of VE as a treatment of choice. Microsurgical VE is considered one of the most technically challenging microsurgeries. Its success rate is highly dependent on the skills and experience of the surgeons...
January 2013: Asian Journal of Andrology
https://www.readbyqxmd.com/read/23160264/microsurgical-epididymal-sperm-aspiration-indications-techniques-and-outcomes
#6
REVIEW
Aaron M Bernie, Ranjith Ramasamy, Doron S Stember, Peter J Stahl
Microsurgical epididymal sperm aspiration (MESA) refers to retrieval of sperm-containing fluid from optimal areas of the epididymis that are selected and sampled using high-power optical magnification provided by an operating microscope. Retrieved sperm are subsequently used for intracytoplasmic sperm injection (ICSI) to induce fertilization and pregnancy. MESA is considered by many experts to be the gold standard technique for sperm retrieval in men with obstructive azoospermia given its high yield of quality sperm, excellent reported fertilization and pregnancy rates, and low risk of complications...
January 2013: Asian Journal of Andrology
https://www.readbyqxmd.com/read/23042447/a-modified-single-armed-technique-for-microsurgical-vasoepididymostomy
#7
Liang Zhao, Chun-Hua Deng, Xiang-Zhou Sun, Yu Chen, Wen-Wei Wang, Liang-Yun Zhao, Ling-You Zeng, Xiang-An Tu
This study is to evaluate the effectiveness of a modified single-armed suture technique for microsurgical vasoepididymostomy (VE) in patients with epididymal obstructive azoospermia. From September 2011 to December 2011, microsurgical two-suture longitudinal intussusception VEs were performed using our modified single-armed suture technique in 17 men with epididymal obstructive azoospermia at our hospital. Two of these patients underwent repeated VEs after previous failed VEs, and one patient underwent unilateral VE because of an occlusion of the left abdominal vas deferens...
January 2013: Asian Journal of Andrology
https://www.readbyqxmd.com/read/22994046/-diagnosis-and-treatment-of-epididymal-obstructive-azoospermia-by-microsurgery
#8
Xue-De Li, Qing-Xin He, Sheng-Hai Fan, Zhi-Yong Jiang, Zhong-Xing Wang
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)...
July 2012: Zhonghua Nan Ke Xue, National Journal of Andrology
https://www.readbyqxmd.com/read/22519558/vasectomy-reversal-using-a-microsurgical-three-layer-technique-one-surgeon-s-experience-over-18-years-with-1300-patients
#9
J U Schwarzer
The technique and the results of microsurgical vasectomy reversal in a single-centre study over 18 years are presented. Both vasovasostomy (VV) and epididymovasostomy (EV) were carried out in a three-layer technique. With strict adherence to the strategy, end-to-end VV was only performed if spermatozoa had been demonstrated at the epididymal stump of the vas. In all other cases, EV was carried out in a preocclusive region of the epididymal tubule. The outpatient procedure of refertilization was associated with a very low complication rate, which underlines its minimal-invasive character...
October 2012: International Journal of Andrology
https://www.readbyqxmd.com/read/22202547/patency-rates-of-microsurgical-vasoepididymostomy-for-patients-with-idiopathic-obstructive-azoospermia-a-prospective-analysis-of-factors-associated-with-patency-single-center-experience
#10
Jing Peng, Yiming Yuan, Zhichao Zhang, Bing Gao, Weidong Song, Zhongcheng Xin, Jie Jin, Wujiang Liu, Yinglu Guo
OBJECTIVE: To evaluate the factors that might be associated with the patency rates of microsurgical vasoepididymostomy for idiopathic obstructive azoospermia. METHODS: 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...
January 2012: Urology
https://www.readbyqxmd.com/read/22099990/nomogram-to-preoperatively-predict-the-probability-of-requiring-epididymovasostomy-during-vasectomy-reversal
#11
David M Fenig, Michael W Kattan, Jesse N Mills, Maria Gisbert, Changhong Yu, Larry I Lipshultz
PURPOSE: Up to 6% of men who undergo vasectomy may later undergo vasectomy reversal. Most men require vasovasostomy but a smaller subset requires epididymovasostomy. Outcomes of epididymovasostomy depend highly on specialized training in microsurgery and, if predicted preoperatively, might warrant referral to a specialist in this field. We created a nomogram based on preoperative patient characteristics to better predict the need for epididymovasostomy. MATERIALS AND METHODS: We evaluated patients who underwent primary vasectomy reversal during a 5-year period...
January 2012: Journal of Urology
https://www.readbyqxmd.com/read/21844967/-factors-affecting-the-results-of-microsurgical-vasoepididymostomy
#12
Jing Peng, Yi-ming Yuan, Zhi-chao Zhang, Bing Gao, Wei-dong Song, Zhong-cheng Xin, Ying-lu Guo, Jie Jin
OBJECTIVE: To evaluate the intraoperative factors affecting the patency of microsurgical vasoepididymostomy. METHODS: From January 2009 to July 2010, 73 men with obstructive azoospermia had undergone longitudinal intussusception vasoepididymostomy (LIVE). The mean age (range) was 31 years (23 to 48) for the patients and their mean infertility was 50.9 months (2 to 180). All the patients were included in three groups by the clinical variables in surgery: anastomosis number, anastomosis sites, epididymal fluid analysis...
August 18, 2011: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/21117935/sperm-retrieval-for-azoospermia-and-intracytoplasmic-sperm-injection-success-rates-a-personal-overview
#13
REVIEW
Sherman J Silber
It is often questioned whether sperm parameters, including whether retrieved or ejaculated, have any effect on intracytoplasmic sperm injection (ICSI) results. Do severe spermatogenic defects affect embryo quality or pregnancy rate? Further, does it matter in azoospermic patients whether the sperm source is testicular or epididymal? Our studies show there is no significant difference in results with ICSI related to any sperm count parameters either with patient's sperm or even with donor sperm. No matter how poor the sperm count, there was no difference from patients with high sperm counts nor even patients using donor sperm...
December 2010: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/21074792/microsurgical-spermatocelectomy-technique-and-outcomes-of-a-novel-surgical-approach
#14
Eric C Kauffman, Howard H Kim, Cigdem Tanrikut, Marc Goldstein
PURPOSE: A microsurgical approach to spermatocelectomy theoretically minimizes the risk of injury to the epididymis and testicular blood supply. We present the technique of microsurgical spermatocelectomy and report our perioperative and recurrence outcomes. MATERIALS AND METHODS: In a 15-year period 23 men with a total of 36 epididymal cystic masses underwent microsurgical resection with confirmation of spermatocele diagnosis by intraoperative identification of sperm in the cyst fluid...
January 2011: Journal of Urology
https://www.readbyqxmd.com/read/19966350/microsurgical-vasoepididymostomy-for-obstructive-azoospermia
#15
K L Ho, M H Wong, P C Tam
OBJECTIVES: To evaluate the efficacy of microsurgical vasoepididymostomy for patients with obstructive azoospermia attending our institutions. DESIGN: Retrospective study. SETTING: Division of Urology, Department of Surgery, Queen Mary and Tung Wah hospitals, Hong Kong. PATIENTS: All patients with obstructive azoospermia due to epididymal obstruction who had undergone microsurgical vasoepididymostomy in the study hospitals from July 2001 to November 2007...
December 2009: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/19482654/advances-in-microsurgery-and-assisted-reproduction-for-management-of-male-infertility
#16
REVIEW
Dan B French, Edmund Sabanegh
Microsurgical techniques are often used for reconstruction of the male genital tract in order to restore fertility. Advances in technology have led to improved outcomes for patients and men previously felt to be incapable of fathering children are now biologic parents. Use of the operating microscope has led to improved outcomes in vasectomy reversal and has made possible the connection of the vas deferens to a single delicate epididymal tubule. In addition to advances in the area of magnification, novel techniques such as robotic assisted surgery or use of biologic sealants hold promise for further refinement...
2009: Frontiers in Bioscience (Elite Edition)
https://www.readbyqxmd.com/read/19247917/obstructive-azoospermia-a-microsurgical-success-story
#17
REVIEW
Cigdem Tanrikut, Marc Goldstein
Microsurgical techniques used in the treatment of male factor infertility have provided a revolutionary adjunct to the advent of intracytoplasmic sperm injection used in conjunction with in vitro fertilization. Previously infertile couples may now parent their own biological children and, in some cases, may even conceive naturally owing to technical advances within the past decade. This article outlines the modern methods currently employed to address vasal and epididymal obstruction with special emphasis on the importance of microsurgical techniques...
March 2009: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/19219057/clinical-observation-of-loupe-assisted-intussusception-vasoepididymostomy-in-the-treatment-of-obstructive-azoospermia-analysis-of-49-case-reports
#18
Guo-Xi Zhang, Wen-Jun Bai, Ke-Xin Xu, Xiao-Feng Wang, Ji-Chuan Zhu
To evaluate the clinical outcomes of loupe-assisted intussusception vasoepididymostomy (VE) in the treatment of epididymal obstructive azoospermia (EOA), we retrospectively analyzed data from 49 patients with EOA who underwent two-suture longitudinal intussusception vasoepididymostomy (LIVE) between 2000 and 2007. The data included the surgical method, postoperative motile sperm count per ejaculation, percentage of progressive motile sperm and patency and pregnancy outcomes. There were a total of 49 men undergoing scrotal exploration, and epididymal obstruction was found in all cases...
March 2009: Asian Journal of Andrology
https://www.readbyqxmd.com/read/18556680/a-decision-analysis-of-treatments-for-obstructive-azoospermia
#19
R Lee, P S Li, M Goldstein, C Tanrikut, G Schattman, P N Schlegel
BACKGROUND: Treatments for post-vasectomy obstructive azoospermia include vasectomy reversal, microsurgical epididymal sperm aspiration (MESA) or percutaneous testicular sperm extraction (TESE) with IVF/ICSI. We examined the cost-effectiveness of these treatments. METHODS: A decision analytic model was created to simulate treatment. Outcome probabilities were derived from peer-reviewed literature and the Society for Assisted Reproductive Technologies database. Procedural costs were derived from a sampling of high-volume IVF centers and the Medicare Resource Based Relative Value Scale...
September 2008: Human Reproduction
https://www.readbyqxmd.com/read/18295271/results-of-vasovasostomy-or-vasoepididymostomy-after-failed-percutaneous-epididymal-sperm-aspirations
#20
Joel L Marmar, Ira Sharlip, Marc Goldstein
PURPOSE: After undergoing vasectomy approximately 4% to 6% of men change their minds and desire more children. In the past they had 2 options: 1) vasectomy reversal and 2) sperm retrieval and intracytoplasmic sperm injection. However, in our practices we began to receive requests for another option: reconstructive microsurgery after failed percutaneous epididymal sperm aspiration. MATERIALS AND METHODS: In this report we combined our collective experience with 8 patients who requested reconstructive microsurgery after failed percutaneous epididymal sperm aspiration and intracytoplasmic sperm injection...
April 2008: Journal of Urology
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