OBJECTIVE: To describe the technique and results of bilateral vasovasostomy using a 3-mm vas cutting forceps angled at 15° (catalog no. NHF-3.15; ASSI) for vasal transection.
DESIGN: Retrospective chart review. Institutional review board approval was granted by Western Institutional Review Board.
SETTING: Single vasectomy reversal center.
PATIENT(S): Men who underwent a bilateral vasovasostomy at a single institution by a single surgeon between 2001 and 2012 and had a minimum of one semen analysis postoperatively or a reported natural conception.
INTERVENTION(S): Before September 14, 2010, a straight-edge vas cutter was used on all vasovasostomy connections; 375 men received a bilateral vasovasostomy and met follow-up criteria. Beginning on September 14, 2010, an angled cutter was used on all vasovasostomy patients, with 194 men meeting the exclusion criteria.
MAIN OUTCOME MEASURE(S): A minimum of 1 × 106 sperm reported on a postoperative semen analysis, or a reported natural conception was used to establish patency.
RESULT(S): The overall vasovasostomy patency rate using the angled vas cutter was 99.5% and was 95.7% using the straight vas cutter.
CONCLUSION(S): The development of an angled vas cutter provides an increased surface area for vasal wound healing to allow for larger tissue diameter for better healing, resulting in high patency rates after vasovasostomy.
Written by:
Crosnoe LE, Kim ED, Perkins AR, Marks MB, Burrows PJ, Marks SH. Are you the author?
Department of Urology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee; Department of Urology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee; Arizona Andrology Laboratory & Cryobank, Tucson, Arizona; Arizona Andrology Laboratory & Cryobank, Tucson, Arizona; International Center for Vasectomy Reversal, Tucson and Phoenix, Arizona; Department of Urology, University of Arizona College of Medicine, Tucson, Arizona.
Reference: Fertil Steril. 2013 Dec 16. pii: S0015-0282(13)03267-6.
doi: 10.1016/j.fertnstert.2013.11.014
PubMed Abstract
PMID: 24355043
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