Comparison of Microsurgical One-layer Vasovasostomy Techniques

Kim, Je Won; Shin, Jae Seop; Lee, Young Tae

Abstract

PURPOSE: The purpose of the study is to compare the outcomes between three different one-layer vasovasostomy techniques: original one-layer, modified one-layer, and V-V type one-layer microsurgical vasovasostomy.
MATERIALS AND METHODS
We retrospectively reviewed the charts and surgical records of all surgical procedures performed on a series of 117 consecutive patients undergoing a microsurgical one-layer, modified one-layer or V-V type one-layer vasovasostomy between May 1995 and March 2000. An original one-layer vasovasostomy was used in 48 men (group 1), a modified one-layer vasovasostomy in 35 men (group 2), and V-V type one-layer vasovasostomy in 34 men (group 3). A successful outcome (patency) was defined as sperm presenting at the follow-ups.
RESULTS
The sperm concentration (million/ml) and motility (%) were as follows: in original one-layer vasovasostomy 17.5 and 32.9, in modified one-layer vasovasostomy 26.1 and 28.5 and in V-V type vasovasostomy 30.5 and 32.3. There were no significant differences in patency (85.4%, 91.4% and 91.2%) and pregnancy rate (56%, 62.5% and 63.6%) of the procedures. If the obstructive interval had been less than 4 years, patency was 87.5% and pregnancy rate was 61.5%, 5 to 9 years 95.8% and 63.4% and 10 years or more 83% and 58.3%. There were no correlations between obstructive interval and rates of patency and pregnancy.
CONCLUSIONS
The patency and pregnancy rate revealed slightly better result in modified one-layer or V-V type one-layer microsurgical vasovasostomy than in original one-layer microsurgical vasovasostomy. However, they had statistically no significant differences in overall.