{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:50:56Z","timestamp":1791417056289,"version":"4.3.3"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003392","name":"Natural Science Foundation of Fujian Province","doi-asserted-by":"publisher","award":["No. 2023J01572"],"award-info":[{"award-number":["No. 2023J01572"]}],"id":[{"id":"10.13039\/501100003392","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Microsurgical vasoepididymostomy is an effective surgical method for treating epididymal obstructive azoospermia but the surgical outcomes can be affected in some non\u2010vasectomized epididymal obstructive azoospermia patients with concurrent vas\u2010deferens obstruction. This study aimed to explore the clinical characteristics and surgical outcomes in non\u2010vasectomized epididymal obstructive azoospermia patients with versus without concurrent vas\u2010deferens obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the clinical characteristics and surgical outcomes in non\u2010vasectomized epididymal obstructive azoospermia patients with versus without concurrent vas\u2010deferens obstruction, aiming to identify predictive factors for concurrent vas\u2010deferens obstruction and evaluate the efficacy of microsurgical vasoepididymostomy in patients with epididymal obstructive azoospermia and concurrent short\u2010segment vas\u2010deferens obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A retrospective analysis of 225 epididymal obstructive azoospermia cases was conducted at the First Affiliated Hospital of Fujian Medical University from November 2016 to March 2023. All patients underwent a comprehensive preoperative evaluation. During surgery, the vas deferens were assessed to determine the presence and extent of obstruction. Depending on the obstruction length, either a standard microsurgical vasoepididymostomy was performed, or the obstructed segment was resected followed by microsurgical vasoepididymostomy. If the remaining length post\u2010resection was insufficient for anastomosis, the procedure was discontinued. Data on patient clinical characteristics, operative findings, and outcomes were collected and analyzed. Logistic regression was used to identify predictive factors for concurrent vas\u2010deferens obstruction, and comparative analysis assessed patency and pregnancy rates between patients with and without concurrent vas\u2010deferens obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 225 patients in the study, 77 (34.22%) presented with epididymal obstructive azoospermia and concurrent vas\u2010deferens obstruction. Logistic regression analysis revealed that \u201cthe history of epididymitis\u201d was a significant predictive factor for epididymal obstructive azoospermia patients with concurrent vas\u2010deferens obstruction (odds ratio\u00a0=\u00a09.06, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The average length of vas deferens obstruction amenable to microsurgical vasoepididymostomy post\u2010resection was 1.31\u00a0\u00b1\u00a00.54\u00a0cm (range from 0.50 to 2.50\u00a0cm). In contrast, cases unsuitable for microsurgical vasoepididymostomy presented an average obstruction length of 15.26\u00a0\u00b1\u00a05.79\u00a0cm (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The patency rates were 82.17% in epididymal obstructive azoospermia patients without concurrent vas\u2010deferens obstruction and 74.14% in those with concurrent vas\u2010deferens obstruction. The pregnancy rates followed a similar trend, at 34.11% and 34.48%, respectively. These differences were not statistically significant (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.05 for both). However, epididymal obstructive azoospermia patients with vas\u2010deferens obstruction exhibited a decreased likelihood of bilateral microsurgical vasoepididymostomy (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and conclusion<\/jats:title><jats:p>Our study identifies a noticeable occurrence of concurrent vas\u2010deferens obstruction in non\u2010vasectomized epididymal obstructive azoospermia patients, with approximately one\u2010third of the cases (34.22%) exhibiting vas\u2010deferens obstruction during surgical interventions. Notably, a small fraction (6.67%) of these individuals chose not to proceed with any microsurgical vasoepididymostomy, even on one side, due to the extensive length of the obstruction. Through logistic analysis, we have demonstrated that \u201cthe history of epididymitis\u201d is a critical predictive factor for the presence of vas\u2010deferens obstruction, underscoring its significance in preoperative evaluations.\u00a0Furthermore, our research confirms that microsurgical vasoepididymostomy is still an effective treatment for epididymal obstructive azoospermia patients with concurrent short\u2010segment vas\u2010deferens obstruction, achieving significant patency and favorable pregnancy rates compared to those patients without vas\u2010deferens obstruction. These insights are pivotal for enhancing surgical strategies and improving fertility outcomes in this patient cohort.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13734","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T12:24:00Z","timestamp":1723465440000},"page":"821-829","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of clinical characteristics and surgical outcomes in non\u2010vasectomized epididymal obstructive azoospermia patients with or without concurrent vas\u2010deferens obstruction"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2443-0836","authenticated-orcid":false,"given":"Songxi","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilang","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maoyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9502-2063","authenticated-orcid":false,"given":"Hong","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7154-3657","authenticated-orcid":false,"given":"Huiliang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Andrology and Sexual Medicine First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)38662-7"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2005.05691.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2012.08.057"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.01.004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0298019"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/1008-682X.175095"},{"key":"e_1_2_9_8_1","volume-title":". WHO Laboratory Manual for the Examination and Processing of Human Semen","author":"World Health Organization","year":"2010"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa781"},{"key":"e_1_2_9_10_1","first-page":"227","article-title":"\u2018How to count sperm properly\u2019: checklist for acceptability of studies based on human semen analysis","volume":"31","author":"Bj\u00f6rndahl L","year":"2016","journal-title":"Hum Reprod"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/1008-682X.159718"},{"issue":"6","key":"e_1_2_9_12_1","article-title":"A descriptive analysis of men diagnosed with epididymitis, orchitis, or both in the emergency department","volume":"13","author":"Bonner M","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871526520666200218115400"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0272.2007.00823.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/1008-682X.155770"},{"key":"e_1_2_9_16_1","first-page":"598","volume-title":"Campbell\u2010Walsh Urology","author":"Goldstein M","year":"2007"}],"container-title":["Andrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/andr.13734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T13:24:45Z","timestamp":1748352285000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/andr.13734"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,12]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/andr.13734"],"URL":"https:\/\/doi.org\/10.1111\/andr.13734","archive":["Portico"],"relation":{},"ISSN":["2047-2919","2047-2927"],"issn-type":[{"value":"2047-2919","type":"print"},{"value":"2047-2927","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,12]]},"assertion":[{"value":"2024-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}