Modification of microsurgical longitudinal intussusception technique of vaso-epididymal anastomosis: A single-center experience

Purpose: Microsurgical intussusception vasoepididymostomy (VE) is well-established treatment option for obstructive azoospermia due to epididymal obstruction. In this study, we evaluated patency rates and complications of our modified longitudinal intussusception technique of microsurgical VE. We have modified the intussusception technique by taking only adventitia of epididymal tubule.Methods: This was a prospective, single-center (tertiary care center) study conducted from February 2008 to January 2016. Study patients were men aged more than 18 years with infertility due to azoospermia. All participants underwent microscopic VE with our modified intussusception technique. Patency rates, complications, and improvement in semen quality were assessed.Results: A total of 42 patients were included in the study and underwent unilateral VE using longitudinal intussusceptions technique. The mean age of the patients was 30.21 years. Of these 42 patients, 40 patients had congenital obstruction. Average operative time was 130.42 min. A total of 36 (85.7%) patients had motile sperms in the epididymal fluid. Patency at 3 months was observed in 25 (62.5%) patients with an average sperm count of 17.1 million/mL. Only two patients (5%) had hemotoma at the site of surgery.Conclusion: Our modified technique of microsurgical longitudinal intussusception VE using epididymal adventitial stitch showed a reasonable patency rate after surgery.