Crossover transseptal vasovasostomy: alternative for very selected cases of iatrogenic injury to vas deferens

Korkes, Fernando; Neto, Oseas Castro Neves

doi:10.1590/s1677-5538.ibju.2018.0445

Cited by 3 publications

(1 citation statement)

References 10 publications

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“… 5 If the abdominal end of the vas deferens was found in the pelvic cavity, a crossover transseptal VV (CTVV) was performed if patency was confirmed on the opposite side of the vas deferens. 6 If the pelvic end of the vas deferens was obstructed while the contralateral testis was absent and the pelvic end of the vas deferens was patent, a CTVV was performed. If patients elected for assisted reproductive technology (ART), a VV was performed and surgery was completed.…”

Section: Methodsmentioning

confidence: 99%

High ligation of the hernia sac in open nonmesh inguinal herniorrhaphy is an important cause of iatrogenic vas deferens injury

Zhao

Zhai

et al. 2023

Asian Journal of Andrology

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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–Darling test was applied to test for Gaussian distribution of data. Fisher’s exact test or Mann–Whitney 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 = 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 (≥12 years or <12 years) or obstructive interval (≥15 years or <15 years). These results underscore that high ligation of the hernial sac warrants extra caution by surgeons during open nonmesh inguinal herniorrhaphy.

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Section: Methodsmentioning

confidence: 99%

High ligation of the hernia sac in open nonmesh inguinal herniorrhaphy is an important cause of iatrogenic vas deferens injury

Zhao

Zhai

et al. 2023

Asian Journal of Andrology

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Surgical procedures for male infertility: an update

Visser

Smith‐Harrison

Krzastek

2021

Current Opinion in Urology

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Purpose of review The aim of this review is to provide an overview of surgical treatment options for male infertility including varicocelectomy, treatment of ejaculatory duct obstruction, vasovasostomy, and sperm extraction, and to review recent advances in techniques and technologies that may improve operative outcomes. Recent findings Microscopic subinguinal varicocelectomy has been shown to have the highest success rates with lowest rates of complications, and may be facilitated by the use of Doppler, indocyanine green angiography, and the 4K3D operating video microscope. The standard treatment for ejaculatory duct obstruction by transurethral resection of the ejaculatory ducts has changed little over time, but vesiculoscopy may allow for temporary dilation of an obstruction to allow for natural conception, while also offering diagnostic capabilities. Use of the robotic platform has gained popularity for vasectomy reversals but controversy remains regarding the cost-effectiveness of this option. Recently, a reinforcing suture technique has been described for vasovasostomy to minimize anastomotic breakdown and reversal failure. Finally, gray-scale and color-enhanced ultrasound may improve ability to predict successful sperm retrieval during extraction procedures. Summary Though the fundamentals of surgical treatment options for male infertility have changed little with time, technological advancements have contributed to improved surgical outcomes over recent years.

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An Updates on Techniques of Microsurgical Vasectomy Reversal- A Mini Review

Kaur¹,

Allahbadia²,

Singh³

2019

Arch Urol

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Following sterilization by vasectomy, men my need future fertility, either due to the loss of a child or a new marriage. Following vasectomy reversal there have been a lot of advances in the field to improve the patency and pregnancy rates, although in the modern era of assisted reproductive technology they are usually not counseled with the ease of sperm retrieval and IVF/ICSI. Here we carried out a systematic analysis using the MeSH terms on the search engine Pubmed, like ''vasectomy reversal'', ''vasovasostomy'(VV)', ''vasoepididymostomy''(VE), ''optimizing success'', ''different sutures'' to be used, ''most modern techniques'' like robotic assisted VV or VE, Video microscopy, analysis of vasal fluid''. We found a total of 1200 articles, out of which we selected 75 articles for this review. No meta-analysis was carried out. Further emphasis has been laid on the training of new urologists to learn this complicated technique so that natural conception can be sought for. Further techniques of some complicated cases are described.

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Crossover transseptal vasovasostomy: alternative for very selected cases of iatrogenic injury to vas deferens

Cited by 3 publications

References 10 publications

High ligation of the hernia sac in open nonmesh inguinal herniorrhaphy is an important cause of iatrogenic vas deferens injury

High ligation of the hernia sac in open nonmesh inguinal herniorrhaphy is an important cause of iatrogenic vas deferens injury

Surgical procedures for male infertility: an update

An Updates on Techniques of Microsurgical Vasectomy Reversal- A Mini Review

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