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  • Title: Microsurgical reversal of vasectomy.
    Author: Ariyaprakai W.
    Journal: J Med Assoc Thai; 1983 Nov; 66(11):663-7. PubMed ID: 6672147.
    Abstract:
    A vasectomy reversal unit established at Ramathibodi Hospital in bangkok, Thailand to deal with patients referred from various parts of the country. Before 1978, the conventional method of end to end reanastomosis was used. Having developed all the basic skills in laboratory microsurgery, microsurgery began to be used in vasovasostomy in 1978. Between January 1978 and August 1981, 31 microsurgical vasectomy reversal procedures were performed. The patients' ages were between 26-41 years with the majority in their 30s. The interval between vasetomy and its reversal varied from 1-15 years. The reasons for their requests to reversal were remarriage, death of a child, or wanting more children. Before vasectomy, most of them had 2 children or less. They were admitted on the operation day and discharged the following day. The operations were performed under general, spinal, or local anesthesia. There were 20 patients available for analysis. The operations were performed at least 6 months previously. 14 had impregnated their wives. Except 1 patient with azoospermia, all the 5 patients whose wives were not pregnant had sperm in their ejaculate. The sperm reappearance rate was 95% and impregnation rate was 70%. For those who impregnated their wives, the time after reversal varied from 1-12 months. 8 patients impregnated their wives within the 1st 6 months after the operation (58%). Early pregnancy seemed to correlate with the short interval between vasectomy and reversal. Although microsurgical repair of the vas is still in its infancy in Thailand, the results reported here seem encouraging. Any reasonable surgeon can be trained to perform microsurgery well. The 2 layer technique to accomplish a watertight and spermtight was deferens anastomosis is described in detail.
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