These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Vaso-vasostomy using microsurgical techniques. A preliminary report.
    Author: Gojaseni P, Visuthikosol V.
    Journal: J Thai Assoc Volunt Steriliz; 1979 Dec; ():85-90. PubMed ID: 12265372.
    Abstract:
    To respond to the many men on the waiting list for surgical recanalization at Ramathibodi Hospital in Bangkok, Thailand, a new service was established as part of the overall family planning service. From October 1978 to June 1979, 16 vasovasostomies were performed using microsurgery. A 2-layered anastomosis with 8-0 Dexon on an opthalmic needle was used for both mucosal and muscularis sutures. A 16X magnification on the microscope was found adequate. After mobilization of the vas through separate scrotal incision, the scar tissues or sperm granuloma, if any, were excised. The cut ends of the vas deferens were examined to determine if the lumens were patent. Hemostatis must be meticulous using a bipolar electrode, and care must be taken not to strip the adventitia of the vas too much for fear of endangering the blood supply. The mucosa could be easily seen under the microscope. A microscopic examination of the sperm fluid was routinely performed. 2 stay sutures were placed diametrically opposite to one another. The special clamps were applied. 3 anterior sutures were inserted first. Appropriate muscularis sutures were inserted only to reinforce the 1st mucosal layer. Of the 16 patients, follow-ups were possible in only 8 cases. There were 2 definite failures (12%). The 1st case in the series that was a failure was because of unfamiliarity with the technique. The 2nd failure was due to severe bilaterial intrascrotal infection with abscess formation. The patients ranged in age from 29-42 years. The duration postvasectomy ranged from 2-15 years. The reasons for requesting reversal were divorce (55%), death of the children (18.7%), wanting more children (13.8%), and psychological (12.5%). Only in 8 patients was it possible to perform sperm analysis after the 1st postoperative months. The ejaculates contained spermatozoa in all cases, excluding the 2 failures. The sperm reappearances occurred as early as 2 weeks postoperatively. The count increased to 20 million/ml at 4 weeks in 1 patient. 1 patient, on whom vasectomy was performed 15 years previously, showed negative smears intraoperatively and poor sperm count postoperatively. The volume of the ejaculates was 3-4 ml. The motility ranged from 40-60%. All patients except 1 had positive smears intraoperatively. Thus far there is no information on the pregnancy rate. In sum, initial results were encouraging.
    [Abstract] [Full Text] [Related] [New Search]