A Low Power Magnification Technique for Reanastomosis of the Vas

Urquhart-Hay, D

doi:10.1111/j.1464-410x.1981.tb03232.x

Cited by 16 publications

(6 citation statements)

References 9 publications

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“…The popularity of the operation, combined with the increase in marital breakdown and separation of relationships, has resulted in more men requesting vasectomy reversal [1,2]. There are various techniques of vasovasotomy (VV), and several published studies show acceptable patency and pregnancy rates after macroscopic [3–6] or optical loupe‐assisted VV [7–10]. However, modern microsurgical techniques, as pioneered by Silber [11,12], remain the ‘gold standard’ with which all other techniques are compared.…”

Section: Introductionmentioning

confidence: 99%

Comparison of modified one‐ and two‐layer microsurgical vasovasostomy

Fischer¹,

Grantmyre²

2000

BJU International

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Section: Introductionmentioning

confidence: 99%

Comparison of modified one‐ and two‐layer microsurgical vasovasostomy

Fischer¹,

Grantmyre²

2000

BJU International

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“…5,6 Modern microsurgical techniques, as popularized by Silber, 7 remain the standard with which all other methods of vasectomy reversal are compared. Patency is over 80% in most microsurgical series, with patency approaching 100% in some reports.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 There are studies demonstrating acceptable patency and pregnancy rates of vasovasostomy (VV) without optical magnification 3,4 and improved success rates with optical loupe assisted VV. 5,6 Modern microsurgical techniques, as popularized by Silber,7 remain the standard with which all other methods of vasectomy reversal are compared. Patency is over 80% in most microsurgical series, with patency approaching 100% in some reports.…”

Section: Introductionmentioning

confidence: 99%

Factors predicting overall success: a review of 747 microsurgical vasovasostomies

Bolduc

Fischer

Deceuninck

et al. 2013

CUAJ

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Objectives: Advances in surgical techniques have improved the outcome of microsurgical vasovasostomy (VV). We performed a retrospective analysis of surgical procedures to determine outcomes and predictors of VV success, to develop Kaplan-Meier Curves for predicting VV outcomes and to evaluate the use of α-glucosidase (AG) to predict outcomes. Patients and Methods:We undertook a retrospective analysis of 747 modified 1-layer microsurgical VV procedures performed between 1984 and 2000. Obstructive interval, partner status, social status preoperatively and method of vasal obstruction, vasal fluid quality and sperm granuloma intraoperatively were compared with outcome results. Parameters evaluated at follow-up included semen analysis, AG concentration in ejaculate fluid and pregnancy rates. Results:The overall patency rate was 86% and pregnancy rates were 33% and 53% at 1 and 2 years after primary VV, respectively. Preoperative factors associated with successful outcome and pregnancy included shorter obstructive interval and same female partner (p < 0.05). Intraoperative factors predicting success included the use of surgical clips instead of suture at vasectomy, the presence of a sperm granuloma, the presence and quality of vasal fluid, and the presence and quality of sperm in vasal fluid. Further, increased AG in the postoperative semen predicted improved patency and pregnancy outcomes. Conclusion:This study confirms the effectiveness of VV for vasectomized men who wish to father children. It also demonstrates that preoperative and intraoperative factors are predictive of the VV outcome. Postoperative AG is also a useful marker of patency and it appears to predict pregnancy outcome. IntroductionVasectomy is a simple and reliable method of permanent contraception that has achieved widespread acceptance. The popularity of the operation combined with increasing marital and relationship separation has resulted in a growing number of men requesting vasectomy reversal.1,2 There are studies demonstrating acceptable patency and pregnancy rates of vasovasostomy (VV) without optical magnification 3,4 and improved success rates with optical loupe assisted VV. 5,6 Modern microsurgical techniques, as popularized by Silber, 7 remain the standard with which all other methods of vasectomy reversal are compared. Patency is over 80% in most microsurgical series, with patency approaching 100% in some reports.3,7-13 However, prediction of patency and preg- with semen analysis (performed according to WHO methods 17 ) including the measurement of AG in ejaculate. Patients were excluded if they did not provide a semen analysis (101 patients) or if they did not attempt to achieve a pregnancy (41 patients). The remaining 605 patients (81%) provided a minimum of 1 semen analysis; all of the samples were analyzed at the same andrology laboratory within our institution, which has previously reported on the use of AG in men with azoospermia. 15,18 Demographic data included patient's age at vasectomy and VV, the obstructive interval be...

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“…Notre série est la première série française de vasovasotomie robot assistée, et la première série qui rapporte l'efficacité sur la reprise de la fertilité spontanée secondaire. Le taux de perméabilité déférentielleà trois moisétait de 100%, légèrement supérieurà celui des techniques de microchirurgie qui ont des taux de perméabilitéà 3 mois entre 90à 95% [2,5,6,8]. Parekattil et al rapportent une série de 20 patients traités par vasovasostomie robot assistée avec un taux de reperméabilisationà 2 mois quiétait aussi de 100% [12] mais ils utilisaient une suture en deux plan.…”

Section: Discussionunclassified

“…Même si de nombreux facteurs comme la durée entre la vasectomie et la chirurgie de remise en continuité, l'obstruction de l'épididyme et la présence d'anticorps antispermatozoïdes, déterminent le taux de grossesse après vasovasostomie, le succès dépend grandement de l'expérience du chirurgien et de la technique utilisée. Initialement, les vasovasostomiesétaient réalisées par des techniques macroscopiques de remises en continuité, avec ou sans l'aide de loupes, et avaient des résultats acceptables en terme de paternité (43à 85%) [2][3][4][5]. Plus récemment, l'utilisation de microscopes et d'instruments de microchirurgie a permis des sutures plus précises.…”

Section: Introductionunclassified

Vasovasostomie robot assistée : résultats sur le spermogramme post-opératoire à 3 mois & la fécondité secondaire à propos de 4 cas

Charles¹

2021

Preprint

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Objective: Evaluation of the efficacy of robotic vasovasostomy post-vasectomy. Patients and methods: We present a retrospective study of four patients aged from 36 to 51 years, who were operated of a vasovasostomy between September 2007 to July 2009. The same surgeon performed a robotic-assisted vasovasostomy, bilateral for three of them and only left unilateral for the last patient who underwent orchidectomy for right testicular seminoma. These patients had a preoperative semen analysis confirmed the absence of sperm after vasectomy. All patients had an outcome of spermatozoa on testicular deferens side in per-operative. The permeability of the distal vas deferens was systematically checked. The success criterion was the presence of spermatozoa in semen control three months. The paternity post vasovasostomy without medically assisted procreation due to father sterility was a secondary endpoint. Results: Four patients had between 0.6 and 27 million sperm per mL in postoperative semen analysis. Three to seventeenth months after the vasovasostomy, the wives of four patients have started a pregnancy between. Conclusion: The robotic vasovasostomy surgery is a technique that enabled this small group of patients having good results in regard to deferential recanalization and to recovery of secondary spontaneous fertility. A larger cohort needs to be evaluated. The medical and economical aspects of this method should be compared to those of usual technics, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

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A Low Power Magnification Technique for Reanastomosis of the Vas

Cited by 16 publications

References 9 publications

Comparison of modified one‐ and two‐layer microsurgical vasovasostomy

Comparison of modified one‐ and two‐layer microsurgical vasovasostomy

Factors predicting overall success: a review of 747 microsurgical vasovasostomies

Vasovasostomie robot assistée : résultats sur le spermogramme post-opératoire à 3 mois & la fécondité secondaire à propos de 4 cas

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