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  • Title: Reversal of vasectomy.
    Author: Jenkins IL, Blacklock NJ.
    Journal: Int J Gynaecol Obstet; 1979; 17(2):144-7. PubMed ID: 41760.
    Abstract:
    Vasovasostomy to reverse a previous vasectomy for sterilization was attempted for 27 men, the procedure being technically impossible in only one case. A testicular biopsy was performed at the time of operation and a number were investigated for cell-mediated immunity to sperm and for the presence of circulating sperm-agglutinating and cytotoxic antibodies. The first 17 cases have been studied and of these there have been 11 pregnancies, ten of which have already come to term with the birth of normal infants, including one set of twins. Of the rest, two are known to have oligozoospermia and four have been lost to follow-up, although two of them were euspermic when last examined. In spite of these encouraging results, it is considered that there are no grounds for alterning the present basis of vasectomy counseling which is that the operation is likely to be irreversible. Operations for reversal of vasectomy were performed for 27 men since June 1972 at the Royal Naval Hospital Haslar (Gosport, England). The first 17 were chosen as the review group in respect to the rate of functional success as 18 months or more have elapsed from the time of surgery. The youngest undergoing vasectomy was age 28 and the oldest age 45, while the youngest at reversal was 30 and the oldest 49. The interval between vasectomy and vasovasotomy varied from 7 to 120 months. 21 of the 27 operations were a consequence of divorce and remarriage. 3 were undertaken following the death of existing children. Each patient was seen at the outset for counseling and examination to assess the feasibility of the operation. The operative technique was the same in each case. The procedure was technically impossible in only 1 case. A testicular biopsy was performed at the time of surgery and a number were investigated for cell-mediated immunity to sperm and for the presence of circulating sperm-agglutinating and cytotoxic antibodies. There have been 11 pregnancies among the first 17 cases, 10 of which have already come to term with the birth of normal infants. Of the rest of the cases, 2 are known to have oligozoospermia and 4 have been lost to follow-up, although 2 were euspermic when last examined. Although the results are encouraging, there are no grounds for changing the current basis of vasectomy counseling which is that the operation is likely to be irreversible.
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