The vasovasostomy is the surgical technique that aims reanastomosis and recanalization of the deferens vas that previously has been sectioned to perform vasectomy.
The intervention is performed under local anesthesia and takes approximately 3 hours. It is done as an outpatient.
Prognostic factors::
- Experience of the surgeon in microsurgery
- Time of Obstruction: It is the time since vasectomy. The success rate ( sperm positive ) according to the latest publications is */**
- < 5 years—96%
- 5-10 years —90%
- 10-15 years—- 65 %
- 15-20 years — 35%
Although semen is positive, it may not achieve pregnancy spontaneously, but it can make possible that assisted reproduction techniques achieve the fecundation.
- Surgical technique : It is essential to use materials and microsurgical techniques.
- Level of obstruction, determines the place where the vasectomy was performed . When farther from the testicle is better because the diameter of the deferens vas is greater.
Preparation
5 hours of fasting and shaving the area
Recovery:
First 3 days with gentle movements and 20 days without relationship (to ensure healing of the suture vas deferens).
Control
1st semen analysis at 8 weeks. If we observe the presence of motile sperms new control is performed at 16 weeks after surgery to observe the outcome of recanalitzation. If you look at a first control azoospermia (sperm abscence), a new analysis is performed 16 weeks after surgery. If this persists until 32 weeks of the procedure. We believe that it has failed.
Other options:
Getting spermatozoa using needle biopsy technique. The sperm obtained is use to practice an in-vitro fertilization (IVF – ICSI).
*Vasectomy Reversal Outcomes Among Patients With Vasal Obstructive Intervals 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 Urol. 2013 Apr;10(4):195-205
