Observations of the Results of 300 Vasovasostomies

¹ Department of Urology, College of Medicine, Seoul National University Hospital, Seoul, Korea

The results of 300 conventional vasovasostomies were evaluated clinically. The operations were carried out bilaterally under spinal or general anesthesia. Depending on the size of the nodule and the level of vasectomy, an end-to-end or side-to-side anastomosis technique was used. A higher rate of success was associated with 1) a shorter period of obstruction, 2) bilateral straight vas-to-straight vas anastomosis, 3) bilateral leakage of fluid with spermatozoa, and/or 4) seven or more days of hospitalization. Patency was established in 84% of the patients, and fertility was restored in 35%. The anatomical success rate in patients in which a two-fold magnifying loupe, four sutures of 6-0 nylon, and a stent were used in anastomosis (this procedure was used before 1970) was below 80%. Thereafter, four- to six-fold magnification and eight sutures of 9-0 nylon without stents were employed and were associated with a success rate of over 85%. The functional success rate increased from 20% before 1970 to 40% thereafter. Although several factors contribute to anatomical or functional failures, the most important is scar formation with sperm and suture granulomas at the anastomosis site. Perhaps these problems will be overcome by the new microsurgical technique for anastomosis.

     Key words: vasectomy, vasovasostomy

Submitted on May 31, 1979
Revised on July 31, 1979
Accepted on August 3, 1979