Current progress on the curative effects of vasoepididymostomy for patients with obstructive azoospermia: An updated systematic review and meta‐analysis of human studies

Wan, Bangbei; Wu, Yamei; Wang, Zhong; Zhou, Zhi; Lu, Weiying

doi:10.1111/andr.13300

Cited by 3 publications

(5 citation statements)

References 81 publications

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Section: Discussionsupporting

confidence: 93%

“…However, it is important to highlight that there was no statistically significant difference in patency rates between the two techniques, regardless of the definition of patency employed. Our findings are similar to those of Wan et al [ 12 ] in showing that the overall mean patency rate of patients in the SA-LIVE group was higher than that of patients in the DA-LIVE group (68% vs. 66.3%). The possible reasons for these differing findings may be attributed to variations in patient characteristics across the included studies and the growing number of recent publications specifically investigating SA-LIVE.…”

Section: Discussionsupporting

confidence: 92%

“…[ 29 ] Our comprehensive analysis of 24 studies involving 1574 patients with EOA revealed a considerable overall patency rate of approximately 68% (95% CI, 63‒72%) for LIVE. Similar findings were obtained from other studies that reported high patency rates for LIVE [ 12 , 30 ]. In comparison, the MVE techniques, such as end-to-end or end-to-side techniques, employed between 1978 and 2004, exhibited lower patency rates of 61.1% [ 31 ].…”

Section: Discussionsupporting

confidence: 92%

“…In recent years, the surgical technique of SA-LIVE has gained increasing popularity in certain countries, including China [3][4][5][6][7][8][9][10][11]. A prior meta-analysis comparing patency rates between DA-LIVE and SA-LIVE found slightly higher patency rates in the SA-LIVE group [12]. However, it is important to approach these conclusions cautiously and interpret them carefully.…”

Section: Introductionmentioning

confidence: 99%

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Comparative evaluation of double- and single-armed two-suture longitudinal intussusception techniques in microsurgical vasoepididymostomy: An updated systematic review and meta-analysis

Xiao,

Zhou,

Chen

et al. 2024

PLoS ONE

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Background This study aimed to compare the outcomes of double−armed two−suture longitudinal intussusception microsurgical vasoepididymostomy (LIVE) and single−armed two−suture LIVE techniques in patients with epididymal obstructive azoospermia (EOA). The main outcomes assessed were patency rates, patency time, semen quality and natural pregnancy rates. Methods Data from patients with EOA who underwent two−suture LIVE were obtained from databases including PubMed, EMBASE, and Web of Science. Weighted data were analyzed using a random−effects model, and weighted mean differences were reported. Results A total of 1574 patients with EOA from 24 studies were included. The overall patency rate was approximately 68% (95% confidence interval [CI]: 63–72%), with a patency time of approximately 4.63 months (95% CI: 4.15–5.12). The sperm concentration reached 26.90 million/ml and the sperm motility was 23.74%. The natural pregnancy rate was 38% (95% CI: 31–46%). The different definitions of patency do not seem to have any meaningful impact when comparing patency rates. There was no significant difference in patency rates, patency time, semen quality and natural pregnancy rates between the double−armed and single−armed LIVE techniques. Conclusion The single−armed LIVE is a potential alternative surgical option when high quality double−needle sutures are not easily accessible.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparative evaluation of double- and single-armed two-suture longitudinal intussusception techniques in microsurgical vasoepididymostomy: An updated systematic review and meta-analysis

Xiao,

Zhou,

Chen

et al. 2024

PLoS ONE

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“…Several systematic evaluations have preliminarily confirmed the safety and efficacy of MVE in the treatment of EOA 1 , 29 . IVE has gradually replaced other surgical techniques for EOA treatment since the beginning of this century, and remains to be one of the most technically challenging urological surgery.…”

Section: Discussionmentioning

confidence: 95%

Outcomes of microsurgical vasoepididymostomy using intussusception technique: a systematic review and meta‑analysis

Wang

Fang

2023

Sci Rep

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A systematic review and meta-analysis of microsurgical vasoepididymostomy (MVE) for treating epididymal obstructive azoospermia (EOA) with different intussusception techniques. We conducted a comprehensive literature search using PubMed, Embase, and the Cochrane Central Register of Controlled Trials, retained literature related to obstructive azoospermia or male infertility and vasoepididymostomy, proactively reviewed other relevant literature, supplemented valuable references, and excluded studies that did not use intussusception and where valuable statistical data were difficult to obtain. Event rate and risk ratio (RR) were estimated. Patency rates were investigated. The influence of motile sperms found in the epididymal fluid, anastomotic sides and sites on patency was evaluated. 273 articles were comprised in this analysis, and 25 observational studies were eventually included, with a total patient sample of 1400. The overall mean patency rate was 69.3% (95% confidence interval [CI] 64.6–73.6%; I2 = 63.735%). We conducted a meta-analysis of the factors affecting patency after microsurgical IVE, finding that the presence of motile sperms in epididymal fluid (RR = 1.52; 95% CI 1.18–1.97%; P = 0.001), anastomosing bilaterally (RR = 1.32; 95% CI 1.15–1.50%; P < 0.0001) and distally (RR = 1.42; 95% CI 1.09–1.85%; P = 0.009) lead to higher patency rates. IVE is an effective treatment for EOA. The presence of motile sperms found in the epididymal fluid, anastomosing bilaterally and distally are significantly correlated with higher patency rates.

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Factors affecting patency time and semen quality in a single-armed microsurgical vasoepididymostomy

Tang,

Xiao,

Chen

et al. 2024

Asian Journal of Andrology

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Although microsurgical vasoepididymostomy (MVE) is an effective treatment for epididymal obstructive azoospermia, some patients may experience delayed patency or suboptimal semen parameters after patency. However, research into patency time, semen quality postpatency, and associated influencing factors remains limited. This study aimed to address these issues by evaluating 181 patients who underwent at least one-sided MVE employing asingle-armed longitudinal intussusception vasoepididymostomy technique, with a follow-up period of over 12 months for 150 patients. The overall patency rate was 75.3%, with 86.0% of patients achieving patency within 6 months following MVE. Unexpectedly, factors such as age, history of epididymitis, duration of surgery, side of anastomosis, sperm motility in epididymal fluid, and the site of anastomosis showed no correlation with patency time. Nonetheless, our univariate and multivariate linear regression analysis indicated that only the site of anastomosis was positively correlated with and could independently predict postoperative total motile sperm count. Therefore, the site of anastomosis might serve as a predictor for optimal postoperative semen quality following the MVE procedure.

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Current progress on the curative effects of vasoepididymostomy for patients with obstructive azoospermia: An updated systematic review and meta‐analysis of human studies

Cited by 3 publications

References 81 publications

Comparative evaluation of double- and single-armed two-suture longitudinal intussusception techniques in microsurgical vasoepididymostomy: An updated systematic review and meta-analysis

Comparative evaluation of double- and single-armed two-suture longitudinal intussusception techniques in microsurgical vasoepididymostomy: An updated systematic review and meta-analysis

Outcomes of microsurgical vasoepididymostomy using intussusception technique: a systematic review and meta‑analysis

Factors affecting patency time and semen quality in a single-armed microsurgical vasoepididymostomy

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