The effect of BMI and age on the outcomes of microsurgical vasoepididymostomy: a retrospective analysis of 181 patients operated by a single surgeon

Abstract

To design a treatment plan for patients with epididymal obstruction, we explored the potential impact of factors such as body mass index (BMI) and age on the surgical outcomes of vasoepididymostomy (VE). In this retrospective study, 181 patients diagnosed with obstructive azoospermia (OA) due to epididymal obstruction between September 2014 and September 2017 were reviewed. All patients underwent single-armed microsurgical intussusception VEs with longitudinal two-suture placement performed by a single surgeon (KH) in a single hospital (Peking University Third Hospital, Beijing, China). Six factors that could possibly influence the patency rates were analyzed, including BMI, age, mode of anastomosis, site of anastomosis, and sperm motility and quantity in the intraoperative epididymal fluid. Single-factor outcome analysis was performed via Chi-square test and multivariable analysis was performed using logistic regression. A total of 159 (87.8%, 159/181) patients were followed up. The follow-up time (mean ± standard deviation [s.d.]) was 27.7 ± 9.3 months, ranging from 12 months to 48 months. The overall patency rate was 73.0% (116/159). The multivariable analysis revealed that BMI and age significantly influenced the patency rate (P = 0.008 and 0.028, respectively). Younger age (≤28 years; odds ratio [OR] = 3.531, 95% confidence interval [95% CI]: 1.397–8.924) and lower BMI score (<26.0 kg m −2 ; OR = 2.352, 95% CI: 1.095–5.054) appeared to be associated with a higher patency rate. BMI and age were independent factors affecting the outcomes of microsurgical VEs depending on surgical expertise and the use of advanced technology.

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

“…Of the 489 articles identified, 24 studies were eligible and included in the meta-analysis [3][4][5][6][7][8][9][10][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. This study's identification and selection process is illustrated in Fig 1 (S1 and S2 Files), according to the PRISMA flow chart.…”

“…In this study, the natural pregnancy rate was strictly defined as the ratio of the number of pregnancies in patients' partners to the number of successfully restored patency cases, excluding ART-induced pregnancies. Four articles [10,[13][14][15] had no data on pregnancy rates. Additionally, three other articles [16][17][18] did not clearly define the calculation of pregnancy rates.…”

“…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].…”