Mp42-17 Totally Extraperitoneal Laparoscopy Assisted Microsurgical Vasovasostomy for the Treatment of Obstructive Azoospermia Caused by Pediatric Bilateral Inguinal Herniorrhaphy

You have accessJournal of UrologyInfertility: Therapy (MP42)1 May 2024MP42-17 TOTALLY EXTRAPERITONEAL LAPAROSCOPY ASSISTED MICROSURGICAL VASOVASOSTOMY FOR THE TREATMENT OF OBSTRUCTIVE AZOOSPERMIA CAUSED BY PEDIATRIC BILATERAL INGUINAL HERNIORRHAPHY Jingpeng Zhao, Huixing Chen, Weidong Wu, Chencheng Yao, Zheng Li, and Peng Li Jingpeng ZhaoJingpeng Zhao , Huixing ChenHuixing Chen , Weidong WuWeidong Wu , Chencheng YaoChencheng Yao , Zheng LiZheng Li , and Peng LiPeng Li View All Author Informationhttps://doi.org/10.1097/01.JU.0001008688.39367.31.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pediatric inguinal hernia repair (IHR) is a common cause of obstructive azoospermia (OA). Yet, surgical treatment for this kind of OA remains difficult with poor fertility outcome. This study is to evaluate the safety and effectiveness of totally extraperitoneal laparoscopy assisted microsurgical vasovasostomy (VV) in the treatment of OA caused by pediatric bilateral IHR. METHODS: Totally, 37 patients with OA caused by pediatric bilateral IHR were enrolled in this study from March 2015 to December 2020 in Shanghai General Hospital. The clinical data and fertility outcomes were collected and analyzed. RESULTS: All patients enrolled had a history of bilateral IHR at the age of 1 to 10 years old. The mean age of patients was 27±4.31 (range: 18–35) years. Totally extraperitoneal laparoscopy (TEP) was applied in 31 patients for the exploration and retrieval of pelvic vas deferens end, and 30 of them underwent microsurgical VV successfully. Among the 6 cases where TEP was not applied, five cases underwent microsurgical anastomosis. Intraoperative exploration revealed that the location of vas deferens injuries included scrotum (2.70%, 1/37), inguinal canal (5.41%, 2/37), pelvic cavity (78.37%, 29/37) and multiple sites (13.51%, 5/37). The mean operation time was 339±96.73 minutes (range: 130 to 510 minutes). There were no surgical complications. Thirty-three cases were followed up for 5∼48 months with 4 cases lost to follow-up. The overall patency rate, pregnancy rate and natural pregnancy rate was 75.86% (22/29), 46.67% (14/30) and 36.84% (7/19, 3 patients without family planning), respectively. And 7 couples conceived through ART, 2 of which using fresh sperm in the ejaculate. CONCLUSIONS: Totally extraperitoneal laparoscopy assisted microscopic vasovasostomy is an effective treatment for patients with OA caused by pediatric bilateral IHR. Source of Funding: 1. National Key Research and Development Program of China (2022YFC2702701)2. National Natural Science Foundation of China (82001530, 81971368 and 82171597) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e690 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jingpeng Zhao More articles by this author Huixing Chen More articles by this author Weidong Wu More articles by this author Chencheng Yao More articles by this author Zheng Li More articles by this author Peng Li More articles by this author Expand All Advertisement PDF downloadLoading ...