Abstract：
OBJECTIVE: To evaluate the influence of epididymitis history on the results of microsurgical vasoepididymostomy and spontaneous pregnancy in patients with epididymal obstruction.
METHODS: Totally 205 patients with epididymal obstruction underwent microsurgical two-suture longitudinal intussusception vasoepididymostomy from January 2014 to December 2016. After surgery, we evaluated the semen quality of the patients every 3 months till conception and compared the rates of patency and spontaneous pregnancy between the patients with and those without an epididymitis history.
RESULTS: The patients ranged in age from 22 to 46 (mean 31) years, 37 (22.2%) with and 126 (77.8%) without an epididymitis history among the 163 patients for whom a 25.4-month follow-up (from 7 to 42 months) was completed. No statistically significant differences were observed postoperatively between the patients with and those without an epididymitis history in the patency rate (73.0% vs 81.7%, P = 0.243), sperm concentration (18 ［1.3－33.6］ vs 15.2 ［0.8－33.4］ ×10⁶/ml, P = 0.710), percentage of progressively motile sperm (27.5 ［0－46.1］% vs 19.3 ［0－41］% (P = 0.592) or rate of spontaneous pregnancy (24.3% vs 38.9%, P = 0.104).
CONCLUSIONS: Microsurgical vasoepididymostomy is an effective method for the treatment of epididymal obstruction, and epididymitis history does not affect the results of the strategy.
METHODS: Totally 205 patients with epididymal obstruction underwent microsurgical two-suture longitudinal intussusception vasoepididymostomy from January 2014 to December 2016. After surgery, we evaluated the semen quality of the patients every 3 months till conception and compared the rates of patency and spontaneous pregnancy between the patients with and those without an epididymitis history.
RESULTS: The patients ranged in age from 22 to 46 (mean 31) years, 37 (22.2%) with and 126 (77.8%) without an epididymitis history among the 163 patients for whom a 25.4-month follow-up (from 7 to 42 months) was completed. No statistically significant differences were observed postoperatively between the patients with and those without an epididymitis history in the patency rate (73.0% vs 81.7%, P = 0.243), sperm concentration (18 ［1.3－33.6］ vs 15.2 ［0.8－33.4］ ×10⁶/ml, P = 0.710), percentage of progressively motile sperm (27.5 ［0－46.1］% vs 19.3 ［0－41］% (P = 0.592) or rate of spontaneous pregnancy (24.3% vs 38.9%, P = 0.104).
CONCLUSIONS: Microsurgical vasoepididymostomy is an effective method for the treatment of epididymal obstruction, and epididymitis history does not affect the results of the strategy.
摘要：
目的：评价附睾炎病史对附睾梗阻患者行显微血管附睾吻合术及自发性妊娠的影响。
方法：于2014年1月至2016年12月对205例附睾梗阻患者行显微外科双缝纵向肠套叠血管附睾吻合术。手术后,我们每3个月对患者的精液质量进行评估,直至受孕为止,并比较有和无附睾炎史患者的通畅率和自然妊娠率.
结果：患者的年龄范围为22至46岁（平均31岁），在163例完成25.4个月（7至42个月）随访的患者中，有37例（22.2％）和126例（77.8％）没有附睾炎史。术后有和无附睾炎病史的患者的通畅率无统计学差异（73.0％vs81.7％，P=0.243),精子浓度(18［1.3－33.6］vs15.2［0.8－33.4］×10/ml，P=0.710),逐渐活动精子的百分比（27.5［0－46.1］％vs19.3［0－41］％（P=0.592）或自然妊娠率（24.3％vs38.9％，P=0.104）。
结论：显微血管附睾吻合术是治疗附睾梗阻的有效方法，附睾炎病史不影响该策略的结果。
方法：于2014年1月至2016年12月对205例附睾梗阻患者行显微外科双缝纵向肠套叠血管附睾吻合术。手术后,我们每3个月对患者的精液质量进行评估,直至受孕为止,并比较有和无附睾炎史患者的通畅率和自然妊娠率.
结果：患者的年龄范围为22至46岁（平均31岁），在163例完成25.4个月（7至42个月）随访的患者中，有37例（22.2％）和126例（77.8％）没有附睾炎史。术后有和无附睾炎病史的患者的通畅率无统计学差异（73.0％vs81.7％，P=0.243),精子浓度(18［1.3－33.6］vs15.2［0.8－33.4］×10/ml，P=0.710),逐渐活动精子的百分比（27.5［0－46.1］％vs19.3［0－41］％（P=0.592）或自然妊娠率（24.3％vs38.9％，P=0.104）。
结论：显微血管附睾吻合术是治疗附睾梗阻的有效方法，附睾炎病史不影响该策略的结果。
