Some of the obstructive azoospermia in azoospermia can be treated surgically, but the surgery is extremely difficult and is a very challenging surgical procedure that requires surgery under a microscope. After years of exploration by the Institute of Urology and Reproductive Medicine of Cornell University in the United States, a mature microsurgical infertility treatment system has been formed and promoted worldwide, and our hospital, with the assistance of Peking University Hospital, has also carried out such surgery and received Our hospital, with the assistance of Peking University Hospital, has also carried out this type of surgery and received good results.
I. Epidemiology
Azoospermia accounts for 1% of all men and 10%-15% of male infertility. Obstructive causes account for 40% of azoospermia
II. Obstructive azoospermia
Definition: The sperm produced by the testes cannot be excreted through the seminal tract.
Classification: Intratesticular obstruction: 15%, epididymal obstruction: 30-67%, vas deferens obstruction, ejaculatory duct obstruction: 1-3%
Diagnosis of obstructive azoospermia
Medical history: history of fertility, history of genitourinary tract infection, history of trauma and surgery
Physical examination: testicular condition, cryptorchidism, development, epididymal vas deferens
Laboratory tests and examinations required.
Semen routine
Urine or urine sediment for spermatozoa
Semen volume
Semen pH
Inhibin B, alpha-glucosidase, seminal plasma fructose
Sex hormone levels Especially testosterone and FSH
Ultrasound: TRUS (transrectal ultrasound)
Testicular biopsy
Chromosome, genetic testing
IV. Objectives of surgical treatment for obstructive azoospermia
To restore the smooth flow of sperm duct and achieve natural conception. Reduce the economic burden
V. Postoperative treatment
C Scrotal brace to dress the wound and brace for 1 month after surgery
C postoperative indwelling urinary catheter removed for 12 hours
C bed rest for 3 days after surgery
C anti-inflammatory symptomatic treatment for 5 days
C relaxation of smooth muscle, reduction of inflammatory response, spermatogenesis and pro-vitality treatment for 3 months
Intercourse can be started 1 month after surgery
Repeat semen examination at 3 months after surgery
CFollow up 3 months~18 months
-There is no small surgery, only small organs
-Surgery is not big, it is precious to be precise
Introduction of microscopic epididymal ejaculatory duct anastomosis surgery in male department of Qingdao University Hospital.
Microscopic minimally invasive surgery in men’s surgery by the Institute of Urology and Reproductive Medicine of Cornell University after years of exploration, the formation of a mature microsurgery treatment system, and the worldwide promotion, in recent years, the international microscopic minimally invasive surgery as a popular procedure, has become the gold standard, microscopic surgery is operated under a microscope magnification of 10-40 times, can clearly see a variety of Microsurgery is surgery under a microscope with a magnification of 10-40 times, which can clearly see various tissues that cannot be seen with the naked eye, and surgery under the naked eye is not at all comparable.
Microscopic epididymal anastomosis surgery is the most complicated, long and challenging surgery among male surgeries, and it is more detailed than vascular and nerve surgery, and the testis is an important part of men and fertility is a major problem for men. In order to achieve these conditions, the hospital is equipped with an operating room, inpatient ward, and advanced operating microscopes, surgical microscopes and other instruments.