Journal List > Korean J Urol > v.50(4) > 1005315

Choo, Cheon, Park, Ji, and Moon: A New Method of Vasovasostomy with the Prolene Stent

Abstract

Purpose

The methods for vasovasostomy are varied, and many authors have reported various success rates. This study aimed to assess a new method for vasovasostomy with a Prolene stent.

Materials and Methods

Among 85 patients who underwent vasovasostomy with a Prolene stent, 69 patients were retrospectively reviewed at our hospital between October 2004 and December 2007. The average age at the time of vasovasostomy was 42.2 years (range: 24.0-52.0 years). The obstructive interval was 6.25 years (range: 0.7-20.0 years). The cases were divided into 2 groups according to obstructive interval: group A (above 8 years) and group B (8 years and less), with 18 (26.1%) and 51 (73.9%) cases, respectively. Patency was defined as a sperm concentration of more than 10×106/ml on semen analysis.

Results

The overall patency and pregnancy rates were 76.8% and 43.4%, respectively. The patency and pregnancy rates of group A were 61.1% and 33.3%. Those of group B were 82.3% and 47.0%. The mean duration to pregnancy was 10.9 months (range: 4-31 months). The mean operation time was 90.2 minutes (range: 50.0-165.0 minutes).

Conclusions

The new method of vasovasostomy with the Prolene stent has good efficacy and safety. Its benefits are the maintenance of good patency, a good pregnancy rate, and a diminished operating time.

Figures and Tables

Fig. 1
The photograph showed a new method of vasovasostomy with prolene stent. The prolene 3-0 suture was inserted in a distal end of vas deferens and penetrated to a proximal end (A). Both ends of the vas deferens were approximated with four nylon 6-0 sutures overlying the prolene 3-0 stent (B).
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Table 1
Patients characteristics
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Table 2
The result of operation associated with various factors
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Table 3
Results of patency and pregnancy rates to related to the time of vasal obstruction
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References

1. Korean Society of Obstetrics and Gynecology. Family planing: gynecology. 1991. Seoul: Calbin Book;227–245.
2. Seo HK, Park NC. 20 years-experience of 1,000 consecutive vasovasostomy. Korean J Fertil Steril. 1998. 25:189–198.
3. Lee KM, Park NC, Yan BQ. Surgical outcome of 153 vasovasostomies on 10 years or more after vasectomy. Korean J Urol. 2003. 44:109–114.
4. Moon KH, Bunge RG. Splinted and nonsplinted vasovasostomy: experimental study. Invest Urol. 1967. 5:155–160.
5. Silber SJ. Microsurgery in clinical urology. Urology. 1975. 6:150–153.
6. Hyun JS. The factors influencing the success rate of vasovasostomy. Vasovasostomy. 1996. Pusan: Yangwoo Book;455–461.
7. Owen ER. Microsurgical vasovasostomy: a reliable vasectomy reversal. Aust N Z J Surg. 1977. 47:305–309.
8. Sharlip ID. Vasovasostomy: comparison of two microsurgical techniques. Urology. 1981. 17:347–352.
9. O'Conor VJ. Anastomosis of vas derferens after purposeful division for sterility. J Urol. 1948. 59:229–233.
10. Ball RA, Steinberg J, Wilson LA, Loughlin KR. Comparison of vasovasostomy techniques in rats utilizing conventional microsurgical suture, carbon dioxide laser, and fibrin tissue adhesives. Urology. 1993. 41:479–483.
11. Derrick FC Jr, Yarbrough W, DAgostino J. Vasovasostomy: results of questionnaire of members of the American Urological Association. J Urol. 1973. 110:556–557.
12. Sullivan MJ, Howe GE. Correlation of circulation antisperm antibodies to functional success in vasovasostomy. J Urol. 1977. 117:189–191.
13. Kim JW, Shin JS, Lee YT. Comparison of microsurgical one-layer vasovasostomy techniques. Korean J Urol. 2001. 42:1185–1190.
14. Lee L, McLoughlin MG. Vasovasostomy: a comparison of macroscopic and microscopic techniques at one instituion. Fertil Steril. 1980. 33:54–55.
15. Kim DH, Jung GW, Yoon JH. The results of microscopic vasovasostomies with different methods in the vasectomized patients. Korean J Urol. 1999. 40:1071–1076.
16. Park JK, Kim HJ, Choi H. A new method in vasovasostomy using permanent silicone tube. Korean J Urol. 1994. 35:1012–1019.
17. Shessel FS, Lynne CM, Politano VA. Use of exteriorized stents in vasovasostomy. Urology. 1981. 17:163–165.
18. Hampel N, Earle AS, Kursh ED, Persky L. Microsurgical anastomosis of vas deferens: an experimental study in the rat. Invest Urol. 1978. 15:395–396.
19. Montie JE, Stewart BH. Vasovasostomy: past, present and future. J Urol. 1974. 112:111–113.
20. Howards SS. Vasovasostomy. Urol Clin North Am. 1980. 7:165–169.
21. Ma YJ, Choi HS. Results of modified one-layer vasovasostomy with optical loupe magnification. Korean J Urol. 1992. 33:1075–1079.
22. Jon SH, Byun CR, Park PA, Chang DJ, Park YI. Result of modified two-layer vasovasostomy and modified one-layer vasovasostomy using stent under microscope. Korean J Urol. 1993. 34:909–913.
23. Belker AM, Thomas AJ Jr, Fuchs EF, Konnak JW, Sharlip ID. Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. J Urol. 1991. 145:505–511.
24. Lipshultz LI, Thomas AJ Jr, Khera M. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Sugrical management of male Infertility. Campbell-Walsh urology. 2007. 9th ed. Philadelphia: Saunders;677–678.
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