Comparative evaluation about factors influencing the success rate of microscopic vasovasostomy

Lee, Sang Bong; Kim, Hyung Jin; Park, Young Kyung

Abstract

From December 1983 to January 1991, 67 of 117 men who underwent microscopic vasovasostomy were evaluated. Patency (anatomical success) and pregnancy (functional success) rates are not significantly different between microscopic two-layer vasovasostomy(86.7%, 50%) and microscopic modified two-layer vasovasostomy (86.5%. 61.4%). We examined postoperative pregnancy rates according to obstructive intervals, gross appearance of vas fluid and sperm granuloma. Pregnancy rates according to obstructive intervals were 55.3 % (5-years less), 43.7% (5 to 10 years) and 25%(10 years of more) respectively. Pregnancy rate after vasovasostomy was inversely related to the duration of the obstructive interva1. Pregnancy rates according to gross appearance of vas fluid were 55.6% (15/27) for watery fluid. 37.5% (3/8) for opalescent fluid and 0%(0,2) for creamy fluid. Pregnancy rates according to presence or absence of histologically' proved sperm granuloma at vasectomy site were 54.5 % (presence) and 50% (absence). Our results suggest that surgical skill rather than method may be more important for the improved success rate of vasovasostomy. and success rates are related to the obstructive interval, gross appearance of vas fluid and the presence or absence of sperm granuloma at vasectomy site.