Vasovasostomy is the surgical technique that aims to anastomosis or recanalize the vas deferens that have previously been sectioned by performing a vasectomy.
The intervention is performed under local anaesthesia and lasts approximately 3 hours. It is done on an outpatient basis.
Prognostic Factors:
- Surgeon’s experience in microsurgery
- Obstruction Time: That is, time elapsed since the vasectomy. The success rate (positive seminograms) according to the latest publications * / **, is:
- <5 years – 96%
- 5-10 years – 90%
- 10-15 years – 65%
- 15-20 years – 35%
Although the seminogram is positive, a pregnancy may not be achieved spontaneously, although it may simplify and make assisted reproductive techniques possible.
- Surgical technique: The use of microsurgical material and techniques is essential.
- Level of obstruction: Determined by where the vasectomy was performed. The further away from the testicle the better, because the diameter of the vas deferens is greater.
Preparation:
5-hour fast and shaving of the area.
Recovery:
Gentle movements the first 3 days and 20 days without practicing intercourse (to ensure healing of the suture of the vas deferens).
Control:
1st semen analysis at 8 weeks. If we observe the presence of motile sperm, a new control is carried out 16 weeks after surgery to observe the result of recanalization. If in the first control we observe azoospermia (absence of sperm), we perform a new analysis 16 weeks after surgery. If this fact persists until 32 weeks after the procedure, we consider that it has not been successful.
Other Alternatives:
Obtaining sperm by puncture and biopsy of the testicle, and with the sperm obtained, practice an In Vitro Fertilization (IVF – ICSI).
* Vasectomy Reversal Outcomes Among Patients With Vasal Obstructive Intervalos Greater Than 10 Years.Grober ED, Karpman E, Fanipour M.Urology. 2013 Nov 6.
** Current status of vasectomy reversal. Schwarzer JU, Steinfatt H.Nat Rev Urola. 2013 Apr; 10 (4): 195-205.