Further clinical experience with CO2 laser in microsurgical vasovasostomy

Herein are reported the results obtained in 14 patients with the performance of vasovasostomy by carbon dioxide (CO2) laser. Fusion coagulation of the vas wall was successfully accomplished as demonstrated by postoperative sperm counts of over 20 million/mL in 86 per cent of the patients, and a pregnancy rate of 43 per cent in the group of patients operated on within less than ten years of original vasectomy. In contrast, those patients undergoing vasovasostomy ten years after original vasectomy had sperm counts of over 20 million/mL in 43 per cent of the cases, with a zero pregnancy rate. A significant reduction in total operative time was achieved as compared to the conventional microsurgical suture technique, corroborating the ability of the CO2 laser to simplify this technique while producing a sperm-tight anastomosis. One of the drawbacks of this operation is that it is not suited for the performance of a vasoepididymostomy which could be required in those cases in which sperm is absent from the vas fluid at the time of vasovasostomy.