{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:25:40Z","timestamp":1788809140024,"version":"build-2803163510"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>\n                    Vasectomy damage is a common complication of open nonmesh hernia repair. This study was a retrospective analysis of the characteristics and possible causes of vas deferens injuries in patients exhibiting unilateral or bilateral vasal obstruction caused by open nonmesh inguinal herniorrhaphy. The site of the obstructed vas deferens was intraoperatively confirmed. Data, surgical methods, and patient outcomes were examined. The Anderson\u2013Darling test was applied to test for Gaussian distribution of data. Fisher\u2019s exact test or Mann\u2013Whitney U test and unpaired t-test were used for statistical analyses. The mean age at operation was 7.23 (standard deviation [s.d.]: 2.09) years and the mean obstructive interval was 17.72 (s.d.: 2.73) years. Crossed (n = 1) and inguinal (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 42) vasovasostomies were performed. The overall patency rate was 85.3% (29\/34). Among the 43 enrolled patients (mean age: 24.95 [s.d.: 2.20] years), 73 sides of their inguinal regions were explored. The disconnected end of the vas deferens was found in the internal ring on 54 sides (74.0%), was found in the inguinal canal on 16 sides (21.9%), and was found in the pelvic cavity on 3 sides (4.1%). Location of the vas deferens injury did not significantly differ according to age at the time of hernia surgery (\n                    <jats:italic toggle=\"yes\">\u2265<\/jats:italic>\n                    12 years or &lt;12 years) or obstructive interval (\u226515 years or &lt;15 years). These results underscore that high ligation of the hernial sac warrants extra caution by surgeons during open nonmesh inguinal herniorrhaphy.\n                  <\/jats:p>","DOI":"10.4103\/aja202312","type":"journal-article","created":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T05:23:27Z","timestamp":1682918607000},"page":"708-712","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["High ligation of the hernia sac in open nonmesh inguinal herniorrhaphy is an important cause of iatrogenic vas deferens injury"],"prefix":"10.4103","volume":"25","author":[{"given":"Jun","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Urology, The Second Affiliated Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Qiang","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Affiliated Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He-Cheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Affiliated Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tie","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Urology, The Second Affiliated Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"R1-20240829","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1016\/j.jviscsurg.2018.04.008","article-title":"Influence of inguinal hernia repair on male fertility","volume":"155","author":"Bouchot","year":"2018","journal-title":"J Visc 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