Epididimovazostomi cerrahisinde patens ve gebelik oranları değişti mi?

Specific treatment of male infertility caused by epididymal obstruction is possible with microsurgical epididymovasostomy (EV). Various techniques have been reported in the literature for EV. From 1978 to 2004, end-to-end or end-to-side anastomosis techniques were generally used. However, intussusception techniques were used in most studies conducted after 2004 due to higher patency and pregnancy rates. Currently, longitudinal intussusception epididymovasostomy technique is accepted as the gold standard. Performing EV bilaterally, anastomosis to a more caudal area, and epididymal fluid containing motile sperm are predictive factors that increase patency. With the increasing popularity of robotic surgery, these technologies have been adapted to microsurgical EV and similar success rates to the traditional microsurgical approach have been reported. Epididimovazostomi is considered one of the most technically difficult procedures, with significant improvements in surgical technique in the last century. High rates of patency and pregnancy have been reported by experienced surgeons using microsurgical techniques in the last decade. In addition, EV has potential advantages over assisted reproductive technologies, such as being less costly, not posing additional risks to the female partner or fetus, and allowing multiple pregnancies. For these reasons, EV is recommended as the first-line treatment for epididymal obstruction. Keywords: infertility, obstructive azoospermia, epididymovasostomy