关键词: 附睾梗阻性无精症, 附睾- 输精管吻合术, 吻合部位, 复通率

Abstract: Objective: To explore the effects of different epididymal anastomosis sites of epididymisvasovasostomy (EV) on recanalization
rate and natural pregnancy rate. Methods: From January 2015 to June 2018, patients diagnosed with concurrent EV in the department
of urology in the First Affiliated Hospital of Dali University were analyzed retrospectively according to the patients intraoperative
conditions. According to the epididymal head, body, and tail of the anastomosis site, they are divided into three groups: A, B, and C.
During the follow-up, a routine semen examination was performed to clarify the reopening situation. Their spouses pregnancy statuses
were followed up through telephone interviews. Results: 33 cases of postoperative recanalization were successful, and the postoperative
recanalization rate was 68.75%, among which the recanalization rate of the three groups A, B, and C was 33.33% (3/9), 66.67% (12/18),
and 85.71% (18/21), respectively. The difference among the groups was significant ( χ 2=7.647, P=0.017<0.05). The spouses of
20 patients were naturally pregnant, and the natural pregnancy rate was 41.67% (20/48). The pregnancy rates of spouses in groups A, B,
and C were 11.11% (1/9), 33.33% (6/18), and 61.90% (13/21) respectively. The difference among the three groups was significant
( χ 2=7.510, P=0.023<0.05). Conclusion: Under the same anastomosis conditions, the anastomosis of the body and tail can significantly
increase the recanalization rate and natural pregnancy rate compared with the head anastomosis.

Key words: epididymal obstructive azoospermia, epididymisvasovasostomy, anastomosis site, recanalization rate