Studies on Vasectomy: IX. Various Factor Bearing on Vasovasostomy Operation.

Lee, Hee Yong

Abstract

A total of 144 vasovasostomies were carried out for 9 years. Various factors which are of importance in influencing the successful vasovasostomies are analyzed and represented as follows: In recent years demand of reanastomosis of the vas deferens increased considerably. An average age of the subjects is 39 and that of their wives,32 in this series. An average interval between vasectomy and vasovasostomy is 4 years. An average number of living children is 2.8 at the time of vasectomy, and 2.3 at the time of vasovasostomy. Merchant and public official are the most commonly encountered occupation in the present series. Coital frequencies are 2.1/week after vasovasostomy. The most common reasons for requesting the vasovasostomy are deaths of children and remarriage. Success rate is considerably higher among younger group than that of the older. Success rate is somewhat higher among group of shorter interval between the operation than that of longer interval group. Success rate is higher among bilateral oozes group than that of any others. The closed dressing technique of the end of splint on the scrotum is found to be most effective in preventing infection. Ordinary end to end anastomosis and folded side to side anastomosis techniques are proved to be the most ideal form of modified operation for the successful vasovasostomies. The most common causes of failure are infection, injuries of blood supply avascular necrosis due to extensive mobilization, inadequate approximation of both vasal ends, and early ambulation in the series. Overall success rate of the author's series is found to be 81 percent and impregnation rate is 36%. Overall results reported by other workers are that success rate regarding appearance of sperm in the semen after the operation is 62%,and that of impregnation after vasovasostomy is 35%. The result of semen assessment performed on 6 case prior to vasectomy and following vasovasostomy showed that postoperative sperm count was two-thirds of preoperative count.