Should All Urologists Performing Vasectomy Reversals Be Able to Perform Vasoepididymostomies if Required?

Chawla, Ashis; O’Brien, Jeanne; Lisi, Michael; Zini, Armand; Jarvi, Keith

doi:10.1097/01.ju.0000135118.43383.b1

Cited by 41 publications

(24 citation statements)

References 19 publications

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“…18 VE can be a much more technically challenging procedure than a vasovasostomy. Some investigators hold the opinion that microsurgeons attempting vasectomy reversal for cases with a significant likelihood of epididymal obstruction should be proficient in performing a VE 19 to provide the best possible outcomes for patients.…”

Section: Evaluations and Diagnosismentioning

confidence: 99%

The evolution and refinement of vasoepididymostomy techniques

Chan¹

2012

Asian J Androl

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Obstructive azoospermia secondary to epididymal obstruction can be corrected by microsurgical reconstruction with vasoepididymostomy (VE). Although alternative management such as epididymal or testicular sperm aspiration in conjunction with intracytoplasmic sperm injection is feasible, various studies have established the superior cost-effectiveness of VE as a treatment of choice. Microsurgical VE is considered one of the most technically challenging microsurgeries. Its success rate is highly dependent on the skills and experience of the surgeons. Various techniques have been described in the literature for VE. We have pioneered a technique known as longitudinal intussusception VE (LIVE) in which the epididymal tubule is opened longitudinally to obtain a larger opening to allow its tubular content to pass through the anastomosis. Our preliminary data demonstrated a patency rate of over 90%. This technique has been widely referenced in the recent literature including robotic-assisted microsurgery. The history of the development of different VE approaches, the preoperative evaluation along with the techniques of various VE will be described in this article.

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Section: Evaluations and Diagnosismentioning

confidence: 99%

The evolution and refinement of vasoepididymostomy techniques

Chan¹

2012

Asian J Androl

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“…Chaw la et al [14] konn ten in ei ner An a lyse von 22 Re fer ti li sie run gen zei gen, dass in 48 eine epi di dy ma le Ob struk ti on die Ursa che für das Ver sa gen der pri mären, mikro chir ur gi schen Re fer ti li sie rung ge we sen war. In den an de ren Fäl len lag eine in suffi zi en te Anas to mo se vor.…”

Section: All Ge Mei Ne Aspek Te Der Be Ra Tungunclassified

Therapie infertiler Paare

Sperling

Eisenhardt

Becker

et al. 2005

Urologe

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Therapy for infertile couples comprises gender-specific as well as couple-specific aspects. Diagnostic and therapeutic procedures focus on the causes of the infertility such as refertilization or epididymovasostomy on the one hand and assisted fertilization with extracted spermatozoa on the other. Using an interdisciplinary approach including urology, gynecology, reproductive medicine and human genetics, the treating physicians are able to fulfil the desire of infertile couples for a healthy child in many cases.

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“…26 ICSI pregnancy rates using sperm from a testicular sperm extraction program are between 19% and 50%. 15,21,24,25,28 The testicular sperm extraction procedure should be offered to all men with non-obstructive azoospermia, but should only be undertaken in a centre with expertise in micro-TESE and where an ICSI laboratory with expertise in handling these samples is available.…”

Section: Non-obstructive Azoospermiamentioning

confidence: 99%

“…14,[21][22][23][24][25][26][27] At present, the optimum way to identify these pockets of sperm is to perform an extensive, surgical dissection of the seminiferous tubules (a testicular sperm extraction) (Level of Evidence 2, Grade of Recommendation B). Large sections of the seminiferous tubules of the testis are examined with an operating microscope.…”

Section: Non-obstructive Azoospermiamentioning

confidence: 99%