Abstract: The popularity of vasovasostomy in recent years can be attributed to improvements in operative techniques, instruments, optics, and most importantly, results. This article addresses the evolution of vasovasostomy, a method of training, the equipment necessary to perform the procedure, and various operative techniques, both macroscopic and microscopic. A brief comparison of postoperative results is included.Recent improvements in operative techniques, instruments, optics, and clinical results have increased the popularity of vasovasostomy. When microsurgical techniques are used, the procedure is effective in reversing vasectomy in 90% of cases. With some form of optical magnification a more precise anastomosis can be performed, but a 2-layer procedure is unnecessary and not cost-effective. Several investigators have utilized the laser to perform vasovasostomy on laboratory animals, but the longterm results remain to be reported. A review of the literature suggests the following observations: 1) surgeons who perform vasovasostomy with regularity obtain better results than those who perform it occasionally, 2) the use of stents is not advantageous if the anastomosis is watertight, 3) the use of optical aids increases the success rate, and 4) the relative merit of specific techniques such as the 2-layer microscopic anastomosis cannot be evaluated definitively because of a lack of data. The success rate of this procedure is greater in cases where vasectomy has occurred less than 10 years prior to reversal, sperm is present in fluid obtained from the testicular limb of the vas at the time of vasovasostomy, and sperm granuloma exist at the vasectomy site.
Publication Year: 1987
Publication Date: 1987-08-01
Language: en
Type: article
Indexed In: ['pubmed']
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