World J Mens Health.  2017 Aug;35(2):115-119. 10.5534/wjmh.2017.35.2.115.

Loupe-Assisted Vasovasostomy Using a Prolene Stent: A Simpler Vasectomy Reversal Technique

• Jeon JC
• Kwon T
• Park S
• Park S
• Cheon SH
• Moon KH

• KMID: 2388447
• DOI: http://doi.org/10.5534/wjmh.2017.35.2.115

Abstract

PURPOSE
Microsurgical vasovasostomy is associated with high patency and pregnancy rates, but is difficult and requires significant effort and time to learn. Therefore, we assessed a simplified loupe-assisted vasovasostomy method using a Prolene stent.
MATERIALS AND METHODS
The medical records of 82 patients who underwent loupe-assisted vasovasostomy with a Prolene stent by a single surgeon between January 2004 and December 2015 were reviewed. The association between the vasal obstructive interval (VOI) and the success rate was evaluated.
RESULTS
The average age at the time of vasovasostomy was 39.8 years (range, 29~57 years). The mean VOI was 6.6 years (range, 1~19 years). The mean operation time was 87.0 minutes (range, 55.0~140.0 minutes). The overall patency and natural pregnancy rates were 90.2% and 45.1%, respectively. The success rate decreased as time after vasectomy increased (odds ratio, 0.869; 95% confidence interval, 0.760~0.993; p=0.039). The cases were divided into 2 groups according to the mean VOI: group A (>7 years) and group B (≤7 years), with 31 cases (37.8%) and 51 cases (62.2%), respectively. The patency and pregnancy rates of group A were 80.6% and 51.6%, respectively, while those of group B were 96.1% and 41.2%, respectively.
CONCLUSIONS
Loupe-assisted vasovasostomy using a Prolene stent is a safe and effective method.

Keyword

Pregnancy; Stents; Vasovasostomy

MeSH Terms

Humans
Medical Records
Methods
Polypropylenes*
Pregnancy
Pregnancy Rate
Stents*
Vasectomy*
Vasovasostomy*
Polypropylenes

Figure

• 

  Fig. 1 Photographs showing our method using the Prolene stent. (A) The tail portion of the Prolene 3-0 suture was inserted into the abdominal end of the vas. (B) The needle penetrated the wall of the testicular end of the vas.

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