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Vasovasostomy.

I Schroeder-Printzen1, Th Diemer, W Weidner

  • 1Department of Urology, University Hospital, Justus Liebig University Giessen, Germany. immo.schroeder-printzen@chiru.med.uni-giessen.de

Urologia Internationalis
|February 20, 2003
PubMed
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Microsurgical vasovasostomy is a highly successful refertilization surgery after vasectomy. This approach offers superior outcomes and cost-effectiveness compared to assisted reproductive techniques like ICSI.

Area of Science:

  • Urology
  • Microsurgery
  • Male Infertility

Background:

  • Vasovasostomy is the primary microsurgical procedure for refertilization post-vasectomy.
  • Obstructions from causes other than vasectomy are uncommon.
  • Pre-operative diagnostics for male infertility are standard.

Purpose of the Study:

  • To review diagnostic and surgical techniques in vasovasostomy.
  • To discuss controversies in intra-operative evaluation and microsurgical techniques.
  • To highlight prognostic factors and compare microsurgery with assisted reproductive techniques.

Main Methods:

  • Review of current literature on vasovasostomy techniques.
  • Discussion of diagnostic approaches and intra-operative assessments.
  • Analysis of prognostic factors influencing surgical success.

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Main Results:

  • Microsurgical vasovasostomy demonstrates high success rates, even in complex cases.
  • Two-layered anastomosis is the gold standard, though single-layered techniques exist.
  • Interval of obstruction, sperm granulomas, and duct length impact prognosis.

Conclusions:

  • Microsurgical refertilization is effective and cost-efficient compared to ART (e.g., ICSI).
  • Advanced microsurgical techniques manage difficult cases and re-vasovasostomy successfully.
  • Further research may clarify optimal intra-operative evaluation and anastomosis techniques.