Techniques for microsurgical reconstruction of obstructive azoospermia

Marmar, Joel L.

doi:10.4103/0970-1591.78438

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…Azoospermia is defined as the complete absence of sperm in the semen and affects 10-15% of infertile men [1]. Approximately 40% of azoospermia patients belong to obstructive azoospermia (OA) [2,3], which is primarily caused by obstruction of vas deferens-epididymis con- nection or epididymal tubule [4].…”

Section: Introductionmentioning

confidence: 99%

A Modified Transversal Two-Suture Microsurgical Intussusception Vasoepididymostomy for the Treatment of Epididymal Obstructive Azoospermia

et al. 2022

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Introduction: We have developed a modified vasoepididymostomy procedure, namely "fenestrated" transversal two-suture microsurgical intussusception vasoepididymostomy. This study aimed to investigate the therapeutic efficacy and outcome of this fenestrated vasoepididymostomy for epididymal obstructive azoospermia. Methods: Microsurgical two-suture transversal intussusception vasoepididymostomy was performed using our modified fenestration technique in 64 obstructive azoospermia (OA) patients due to epididymal obstruction at our hospital. Fenestration means making an opening on the epididymal tubule wall. The edges of the epididymal tubule "window" were stitched transversally (2 stitches) using the two double-armed 9-0 atraumatic suture. The epididymal tubule was anastomosed to the lumen of the vas deferens. The patency rate and pregnancy rate were assessed. Results: Of the 64 OA patients, 45 received bilateral microsurgical two-suture transversal intussusception vasoepididymostomy while 19 underwent unilateral microsurgical two-suture transversal intussusception vasoepididymostomy. All of the patients were followed up after the operation. The follow-up period ranged from 4 to 54 months. Among 45 cases of bilateral surgery, the patency rate was 88.89% (40/45), and the natural pregnancy rate was 28.89% (13/45). After the patency was confirmed postoperatively, 3 cases had recurrent OA, of which 2 cases had return of sperm to the ejaculate by oral antibiotics and scrotal self-massage. As for the 19 cases of unilateral microsurgery, the patency rate was 68.42% (13/19), and the natural pregnancy rate was 21.05% (4/19). Conclusion: The fenestrated transversal two-suture microsurgical intussusception vasoepididymostomy can achieve a good patency rate in OA patients, and did not increase the difficulty and duration of the procedure.

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Section: Introductionmentioning

confidence: 99%

A Modified Transversal Two-Suture Microsurgical Intussusception Vasoepididymostomy for the Treatment of Epididymal Obstructive Azoospermia

et al. 2022

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“…About 10-15% of infertile men present with azoospermia, and non-obstructive azoospermia (NOA) is the cause in about 60% of these men [Marmar 2011]. With the application of intracytoplasmic sperm injection (ICSI) and testicular sperm extraction techniques, sperm can be retrieved in NOA patients [Yang and Liu 2012].…”

Section: Introductionmentioning

confidence: 99%

ThePGAM4gene in non-obstructive azoospermia

Jin

Pan²,

Wang³

et al. 2013

Systems Biology in Reproductive Medicine

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Non-obstructive azoospermia (NOA) is considered to be a severe infertility factor due to impaired spermatogenesis with the consequent absence of spermatozoa in the ejaculate. However, the underlying etiology and mechanism(s) remain elusive. The aim of this study was to investigate the mutation and association of single nucleotide polymorphisms (SNPs) of the phosphoglycerate mutase 4 (PGAM4) gene in Chinese Han infertile men with NOA. The entire coding region of PGAM4 gene was sequenced from 214 participants including 103 infertile men with NOA and 111 controls with proven fertility. Screening was carried out using PCR and DNA sequencing to identify novel mutations and SNPs of the entire coding region of PGAM4. No mutation, including A138C or G539A, was detected in the coding region of PGAM4. One novel synonymous mutation (G111A, rs20100573) in control individuals was identified. There was no significant difference between NOA patients and controls in the G75C (rs138178131) frequencies (1.9% (2/ 103) and 4.5% (5/111), respectively, P = 0.292 and P = 0.374, adjusted by age). PGAM4 coding region mutations were not observed and the G75C polymorphism is not associated with NOA susceptibility among the Chinese Han population.

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