Vasovasostomy

Schroeder‐Printzen, I.; Diemer, Thorsten; Weidner, W.

doi:10.1159/000068182

Cited by 16 publications

(8 citation statements)

References 65 publications

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“…For this reason, vasectomy reversal is the method of choice for these patients, being less expensive than ICSI [6][7][8]11] . Moreover, vasectomy reversal shows a little higher pregnancy rate than ICSI in patients with obstructive azoospermia and it is a physiological method that allows multiple pregnancies [8,10,11] . The mean age of the patients was 47 years, which is somewhat higher than that previously reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is important for the urologist, who will perform a vasectomy, to be aware of the possibility that a vasectomy reversal may be performed in the future. In the USA, 79% of the vasectomies are performed by urologists, 10.1% by family physicians and 10% by generalists [19] . In Brazil, this data is not available and may have considerable regional variation.…”

Section: Discussionmentioning

confidence: 99%

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Vasectomy Reversal: A Seven-Year Experience

Busato¹

2009

Urol Int

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Introduction: Since the demand for vasectomy reversal is increasing and many populations in Brazil and other countries show distinct characteristics, this study was carried out as an effort to determine factors and characteristics associated with the success rate of reversal in a population in Southern Brazil. Patients and Methods: We reviewed 29 cases of vasectomy reversal performed over a 7-year period using the single-layer technique under microscopic magnification. Results: Mean patency, pregnancy, and birth rates were 75, 41.7 and 29%, respectively. The patency and pregnancy rates were 92.3 and 38.5%, respectively, for time intervals since vasectomy <10 years and 63.6 and 45.4%, respectively, for intervals >10 years. Patency and pregnancy rates were 87.5 and 50%, respectively, for patients who had their vasectomy performed by a urologist, and 50 and 25%, respectively, for those who had their vasectomy performed by a generalist surgeon (p < 0.05). Conclusions: High patency and pregnancy rates are associated with time intervals since vasectomy of <10 years and vasectomies performed by urologists. There was no significant difference in the anastomosis time between the first 12 procedures and the next 12 procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vasectomy Reversal: A Seven-Year Experience

Busato¹

2009

Urol Int

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“…In this study, the reanastomosis were performed immediately after vasotomy and in vivo experience usually reveals a significant discrepancy in lumen sizes, hence, the theoretical reason for 2-layer closures. When both methods are compared, one would opt for the faster and easier method to be performed (11). Based on these reasons, anastomosis with fibrin glue was compared to the one-layer technique with mucosa-to-mucosa alignment.…”

Section: Commentsmentioning

confidence: 99%

“…Several techniques using microanastomosis show good results, with respect to both anastomosis patency and pregnancy rate, between 80 to 90%, and 50 to 80%, respectively (5)(6)(7)(8)(9)(10)(11). Thus, the main objective of this study is to devise a new technique or to improve an existing one that would allow a faster procedure (12,13).…”

Section: Introductionmentioning

confidence: 99%

Comparison of vasovasostomy with conventional microsurgical suture and fibrin adhesive in rats

Busato

Marquetti²,

Rocha

2007

Int. braz j urol.

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Objective: Microsurgical procedures are currently the gold standard for vasovasostomy with excellent results, but it takes an increased operative time demanding special training and experience in microsurgery. The objective of this study is to reach the same results with reduced operative time. Materials and Methods:Male adults Wistar rats were divided into 3 groups: I) 20 rats in control group, II) 20 with conventional one-layer microsuture and III) 20 with fibrin glue. After four weeks each rat was left for two weeks with two female rats. Results: The fertility rates were 80% in group I, 70% in group II and 65% in group III (p > 0.05). In group II granuloma was found in 75% of the rats, while in group III in 85% (p < 0.05). Anastomosis was considered with patency in 75% and 80% of the rats in groups II and III (p > 0.05). Overall operative time was 41.7 ± 2.49 and 28.55 ± 1.14 minutes in groups II and III (p < 0.05) and the time to anastomosis of 24.6 ± 1.8 and 9.35 ± 0.78 minutes (p < 0.05), respectively. Conclusions: We can conclude that vasovasostomy with fibrin adhesive has the same results of the conventional microsurgery technique but with a reduced operative time and a simplified procedure.

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“…This is increased to 80% by the use of magnifying loupes or an operating microscope. Consequently, it has been recommended that vaso‐vasostomy should only be performed with intra‐operative magnification [22–25]. Epididymo‐vasostomy is an alternative to vaso‐vasostomy when vaso‐vasal anastomosis is not technically possible owing to proximal vasal division in the convoluted portion, and may be required in up to 30% of men presenting for reversal of their vasectomy [26,27].…”

Section: Introductionmentioning

confidence: 99%

UK practice regarding reversal of vasectomy 2001–2010: relevance to best contemporary patient management

et al. 2012

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Study Type – Practice trends (survey) Level of Evidence 2c What's known on the subject? and What does the study add? Approximately 6% of men who have had a vasectomy subsequently decide to have it reversed. For such men there are various options available, including vasal reconstruction, surgical sperm retrieval with assisted reproductive techniques, use of donated sperm or adoption. The decision‐making process with regard to the most appropriate management is challenging and the urologist requires both an intimate knowledge of the advantages and disadvantages of each of the available options and the opportunity to counsel a couple appropriately. The study confirms that patient management after previous vasectomy is a complex process, demanding detailed knowledge about the availability and outcomes of alternatives to vasectomy reversal. It recommends that couples should not be seen by urologists with diverse interests but by those with appropriate knowledge of all of the factors influencing outcome and the available management options and their costs. Urologists should also have appropriate facilities to offer intra‐operative demonstration of and, potentially, storage of sperm. OBJECTIVES To review the management of men presenting for reversal of vasectomy amongst consultant members of the British Association of Urological Surgeons (BAUS) between 2001 and 2010. To make recommendations for contemporary practice. SUBJECTS AND METHODS Three consecutive questionnaire‐based surveys were undertaken by BAUS consultant members in 2001, 2005 and 2010. Standard questionnaires were sent on each occasion asking urologists about their counselling of couples regarding options in achieving a conception, expectation of outcome from reconstructive surgery and the techniques of vaso‐vasostomy used. In 2005 additional information was obtained about the availability of fertility treatments and sub‐specialization of the urologist and in 2010 about the eligibility criteria for in‐vitro fertilization (IVF) treatment and synchronous sperm retrieval. RESULTS Overall there was a 47% response rate with >80% of respondents still performing vaso‐vasostomy. More than 75% of respondents were doing <15 procedures a year and <50% of respondents counselled couples about other management options. Only 41% gave their personalized outcomes from vaso‐vasostomy, whilst >80% were using some form of magnification intra‐operatively. Members of the BAUS section of andrology were more likely to discuss options for becoming a parent and criteria for IVF treatment, to present their individualized outcomes from vaso‐vasotomy and to carry out >15 procedures a year than urologists with no andrological affiliation. CONCLUSIONS Patient management after previous vasectomy is a complex process necessitating detailed knowledge concerning the availability and outcomes of alternatives to vaso‐vasostomy. Couples should not be seen by urologists with diverse interests but by those with appropriate knowledge of all of the factors influencing outcome. Vaso‐vasostom...

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Vasovasostomy

Cited by 16 publications

References 65 publications

Vasectomy Reversal: A Seven-Year Experience

Vasectomy Reversal: A Seven-Year Experience

Comparison of vasovasostomy with conventional microsurgical suture and fibrin adhesive in rats

UK practice regarding reversal of vasectomy 2001–2010: relevance to best contemporary patient management

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