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  • Title: Microsurgical reversal of vasectomy.
    Author: Martin DC.
    Journal: Am J Surg; 1981 Jul; 142(1):48-50. PubMed ID: 7258514.
    Abstract:
    1 urologist's experience with vasovasotomy employing the operating microscope is reported. An attempt was made to assess the results of surgery in relation to the many clinical variables. 41 reverse vasectomy and surgical procedures were carried out in 40 patients, ranging in age from 26 to 53 years, over the January 1977 and December 1980 period. The interval between vasectomy and reversal procedure was 1-19 years. The surgical procedures were performed in an outpatient surgical unit. A solution of 1/2% Marcaine with epinephrine was used for local anesthesia. 2 separate high scrotal incisions were found to provide the best access to the vas deferens. The site of vasectomy was excised by cutting the vas with a sterile razor blade. A 2-layer anastomosis was created. Semen analysis was requested 3 months postoperatively. The analysis was made in a university research laboratory in 1/2 of the patients, and, because of geographic dispersion, 1/2 of the semen analyses were made in private laboratories in which there was no quality control. The mean sperm count was 48.4 million/ml. 4 patients never had sperm in the ejaculate. 2 patients with initial counts of 58 million and 18.8 million/ml had negative counts after 5 and 18 months. In all, 10 patients had sperm counts less than 20 million/ml. The mean motility in all patients was 33%. The incidence of abnormal forms ranged from 5 to 85% with a mean of 33.5%. 21 patients followed up for at least 1 year produced 9 pregnancies (43%). All but 2 patients had seminal fluid from the proximal vas on 1 or both sides. 6 patients had postoperative hematomas, but only 1 was large enough to involve the inguinal canal. 13 patients had sperm agglutinating antibodies and 8 had immobilizing antibodies.
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