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  • Title: Vasovasostomy with use of medical needle as a support.
    Author: Zhu XY, Shi YX.
    Journal: J Urol; 1988 Jan; 139(1):53-4. PubMed ID: 3336105.
    Abstract:
    Between May 1981 and December 1985 we performed vasovasostomy using a needle as a support in 43 patients who had undergone vasectomy for family planning. The operation is simple with little surgical trauma and few complications. All 39 patients who underwent semen analysis had return of spermatozoa. Pregnancy resulted in 27 of 34 patients (79.41 per cent) who attempted conception. The results were satisfactory. The procedure is described, and the complication and success rates are analyzed. Between May 1981 and December 1985, urologists performed vasovasostomy on 43 26-42 year old patients at Xiangxi Autonomous Prefecture Hospital in Jishou City in Hunan province, China. Mean amount of time since vasectomy was 27.5 months (range = 5 months to 14 years). The leading reason for the surgical rejoining of the cut ends of the vas deferens was a desire for children (84%). The other reason was a vasectomy complication. The urologists used a needle to support the 2 cut ends of the vas deferens while they sutured the ends with 5-8-zero nylon. They did not remove the vasectomy nodules, but separated them and removed the vas ends and the former suture lines without harming the main blood vessel and nerves. The urologists did not detect any new nodules during postoperative reexamination in 24 patients. Total operative time was only 60-80 minutes. This new anastomosis method did not require an intravasal stent, microsurgical equipment, or special skills. 4 men did not return for semen analyses. The patency rate for the 39 remaining men stood at 100%. Of the 36 men who wanted another child, 2 were lost to follow up. 79.41% (27) of the remaining men were able to impregnate their partners. 5 experienced a sperm count of at least 20 million/ml. 1 exhibited transient fertility. 1 was unable to cause conception and did not return to the hospital for follow up examinations. None of the men experienced bleeding after the vasovasostomy. 1 man experienced a small infection at the incision and another suffered vasitis. Just 5.88% of the 34 men who wanted a child had delayed complications. Accurate anastomosis of the 2 vas ends, the uncompromising aseptic technique, division of the nodule, and total removal of the residual ends and the former ligature accounted for the high patency and pregnancy rates and the low early complication rate.
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