The evolution and refinement of vasoepididymostomy techniques

被引:36
作者
Chan, Peter T. [1 ]
机构
[1] McGill Univ, Royal Victoria Hosp, Dept Urol, Ctr Hlth, Montreal, PQ H3A 1A1, Canada
关键词
longitudinal intussusception vasoepididymostomy (LIVE); intracytoplasmic sperm injection (ICSI); male infertility; microsurgery; obstructive azoospermia; vasoepididymostomy (VE); INTRACYTOPLASMIC SPERM INJECTION; ROBOTIC MICROSURGICAL VASOVASOSTOMY; TO-SIDE VASOEPIDIDYMOSTOMY; IN-VITRO FERTILIZATION; OBSTRUCTIVE AZOOSPERMIA; VASECTOMY REVERSAL; MALE-INFERTILITY; INTUSSUSCEPTION VASOEPIDIDYMOSTOMY; EPIDIDYMAL OBSTRUCTION; OCCLUSIVE AZOOSPERMIA;
D O I
10.1038/aja.2012.80
中图分类号
R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
摘要
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. Various techniques have been described in the literature for VE. We have pioneered a technique known as longitudinal intussusception VE (LIVE) in which the epididymal tubule is opened longitudinally to obtain a larger opening to allow its tubular content to pass through the anastomosis. Our preliminary data demonstrated a patency rate of over 90%. This technique has been widely referenced in the recent literature including robotic-assisted microsurgery. The history of the development of different VE approaches, the preoperative evaluation along with the techniques of various VE will be described in this article. Asian Journal of Andrology (2013) 15, 49-55; doi:10.1038/aja.2012.80; published online 19 November 2012
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收藏
页码:49 / 55
页数:7
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