全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

输精管附睾显微吻合术治疗梗阻性无精症44例分析

, PP. 2481-2484

Keywords: 梗阻性无精症,输精管附睾吻合,治疗

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的分析附睾梗阻所致无精症患者行输精管附睾显微吻合术后的复通率和自然怀孕率以及吻合部位对复通率的影响。方法回顾分析我院2012年3月至2014年3月收治的44例附睾梗阻所致无精症患者行输精管附睾显微吻合术的临床资料,根据术中发现和吻合部位的不同等情况,随访观察并分析患者术后的复通率和自然怀孕率。结果44例患者年龄20~58(34.7±8.3)岁。包括双侧吻合39例,单侧吻合5例;行附睾尾部吻合25例,附睾体部吻合8例,附睾头部吻合11例。平均随访时间9.57(3~24)个月,总体复通率为70.5%(31/44),自然怀孕率为22.7%(10/44)。精子密度0~42×106/mL[(13.97±13.07)×106/mL],精子活力0~57%(A+B级)。双侧吻合、单侧吻合的复通率分别为76.9%、20.0%,自然怀孕率分别为28.2%、0。附睾尾部、附睾体部、附睾头部吻合的复通率分别为80.0%、75.0%、45.5%。结论输精管附睾显微吻合术是治疗附睾梗阻所致无精症患者的有效方法,有条件进行双侧吻合、近附睾尾部吻合可获得更高的总体复通率和自然怀孕率。

References

[1]  Jarow J, Sigman M. The management of obstructive azoospermia: AUA best practice statement[M]. Linthicum: American Urological Association Education and Research, 2010. [2]Dohle G R, Colpi G M, Hargreave T B,et al. EAU guidelines on male infertility[J]. Eur Urol, 2005, 48(5): 703-711. [3]Peng J, Yuan Y, Cui W,et al. Causes of suspected epididymal obstruction in Chinese men[J]. Urology, 2012, 80(6): 1258-1261. [4]Peng J, Yuan Y, Zhang Z,et al. Patency rates of microsurgical vasoepididymostomy for patients with idiopathic obstructive azoospermia: a prospective analysis of factors associated with patency--single-center experience[J]. Urology, 2012, 79(1): 119-122. [5]Chan P T, Brandell R A, Goldstein M. Prospective analysis of outcomes after microsurgical intussusception vasoepididymostomy[J]. BJU Int, 2005, 96(4): 598-601. [6]Zhao L, Deng C H, Sun X Z,et al. A modified single-armed technique for microsurgical vasoepididymostomy[J]. Asian J Androl, 2013, 15(1): 79-82. [7]Hansen M, Kurinczuk J J, Bower C,et al. The risk of major birth defects after intracytoplasmic sperm injection and in vitro fertilization[J]. N Engl J Med, 2002, 346(10): 725-730. [8]Chan P T, Lee R, Li P S,et al. Six years of experience with microsurgical longitudinal intussusception vasoepididymostomy (LIVE): a prospective analysis[J]. J Urol, 2008, 179(4): 591-592. [9]Peng J, Yuan Y, Zhang Z,et al. Microsurgical vasoepididymostomy is an effective treatment for azoospermic patients with epididymal obstruction and prior failure to achieve pregnancy by sperm retrieval with intracytoplasmic sperm injection[J]. Hum Reprod, 2014, 29(1): 1-7 [10]Marmar J L, Sharlip I, Goldstein M. Results of vasovasostomy or vasoepididymostomy after failed percutaneous epididymal sperm aspirations[J]. J Urol, 2008, 179(4): 1506-1509. [11]Chan P T. The evolution and refinement of vasoepididymostomy techniques[J]. Asian J Androl, 2013, 15(1): 49-55. [12]Kamal A, Fahmy I, Mansour R,et al. Does the outcome of ICSI in cases of obstructive azoospermia depend on the origin of the retrieved spermatozoa or the cause of obstruction? A comparative analysis[J]. Fertil Steril, 2010, 94(6): 2135-2140. [13]Osmanagaoglu K, Vernaeve V, Kolibianakis E,et al. Cumulative delivery rates after ICSI treatment cycles with freshly retrieved testicular sperm: a 7-year follow-up study [J]. Hum Reprod, 2003, 18(9): 1836-1840. [14]张国喜, 白文俊, 许克新, 等. “套叠式”输精管附睾吻合术治疗梗阻性无精子症[J]. 中华男科学杂志, 2008,22(4): 50-52.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133