Vasectomy reversal
Amelar, R.D.; Dubin, L.
Journal of Urology 121(5): 547-550
1979
ISSN/ISBN: 0022-5347 PMID: 439245 DOI: 10.1016/s0022-5347(17)56873-1Document Number: 374187
Although the pace is slower, the need for reversal of the vasectomy procedure increases as vasectomy increases in popularity. Reasons for requesting vas reanastomosis and restored fertility are various. Recently, there have been significant advances in the surgical techniques for vasectomy reversal to restore fertility after previous voluntary sterilization by bilateral vasectomy, leading to improved results. Anatomical and physiological considerations, results, and the surgical technique of vasovasostomy are reviewed. Reviewing the literature on reported experiences with vasectomy-reversal operations it can be found that after vasectomy various authors have reported that sperm cells have returned to the ejaculate in 30-98% of the series. Spontaneous recanalization of the vas does occur in 1-2% of the cases after vasectomy. In the surgical technique of vasovasostomy, a non-splinted technique with surgical ocular loupes of 4 power magnification and 8, 6-zero prolene sutures was used, and the entire procedure is described in detail. The reasons for the marked discrepancy between the presence of sperm after vasovasostomy and the pregnancy rates continues unknown. The improved results with vas reanastomosis recently reported by urologists using various techniques may be related to the elimination of the use of exteriorized intra-vasal splints that usually were removed several days or weeks postoperatively. Currently, long-term comparative results are unavailable.