Vasovasostomy: Macroscopic approach and retrospective review

The objective of this study was to review our 5-year experience with macroscopic vasovasostomy. A series of 160 consecutive patients who underwent macroscopic vasovasostomies between 1991 and 1996 at Madigan Army Medical Center were studied. A modified one-layer anastomotic technique using 7-0 or 8-0 Prolene sutures was utilized. Results showed that 87% of patients who underwent bilateral vasectomy reversal showed return of sperm to the ejaculate with a mean progressive sperm motility of 32.2%. Clinical success was measured by successful pregnancies in 50% of patients in whom <5 years had elapsed since vasectomy. The average operative time was 1 hour 15 minutes. Although slightly better results have been obtained using the microscopic approach, vasovasostomy performed under loupe magnification has the advantage of reduced cost, decreased operative time, and a lower operator skill level.