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Vasovasostomy and predictors of vasal patency: A systematic review.

Elzanaty, Saad LU and Dohle, Gert R (2012) In Scandinavian journal of urology and nephrology 46(4). p.241-246
Abstract
About 3-6% of vasectomized men requested vasectomy reversal, for various reasons. Vasal patency (VP) is an important surrogate outcome of vasectomy reversal. This article reviews the impact of surgical skills, surgical approaches, intraoperative vasal fluid characteristics and the length of obstructive interval on VP. Based on the best available evidence, the rate of patency is related to the operative frequency of the surgeons, with better results obtained by surgeons who perform the operations at least 10 times annually. Microsurgical vasovasostomy is the preferred technique for durable good results. One-layer vasovasostomy and two-layer vasovasostomy seem to be equal with regard to VP. The rate of patency following vasovasostomy in the... (More)
About 3-6% of vasectomized men requested vasectomy reversal, for various reasons. Vasal patency (VP) is an important surrogate outcome of vasectomy reversal. This article reviews the impact of surgical skills, surgical approaches, intraoperative vasal fluid characteristics and the length of obstructive interval on VP. Based on the best available evidence, the rate of patency is related to the operative frequency of the surgeons, with better results obtained by surgeons who perform the operations at least 10 times annually. Microsurgical vasovasostomy is the preferred technique for durable good results. One-layer vasovasostomy and two-layer vasovasostomy seem to be equal with regard to VP. The rate of patency following vasovasostomy in the convoluted vas and vasovasostomy in the straight vas is comparable. The patency rate is high in men with clear intraoperative vasal fluid in at least one vas. VP is still high among patients with a long obstructive interval. In conclusion, surgical skills and intraoperative vasal fluid characteristics are the most important predictors of VP. Postoperative semen quality and the age of the female partner determine the chance of spontaneous conception in these couples. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian journal of urology and nephrology
volume
46
issue
4
pages
241 - 246
publisher
Taylor & Francis
external identifiers
  • wos:000306479900001
  • pmid:22452615
  • scopus:84863873049
ISSN
1651-2065
DOI
10.3109/00365599.2012.669790
language
English
LU publication?
yes
id
6fe848ed-3586-439f-b2cc-c6454544f8bc (old id 2431404)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22452615?dopt=Abstract
date added to LUP
2012-04-03 13:56:07
date last changed
2017-01-01 06:23:51
@article{6fe848ed-3586-439f-b2cc-c6454544f8bc,
  abstract     = {About 3-6% of vasectomized men requested vasectomy reversal, for various reasons. Vasal patency (VP) is an important surrogate outcome of vasectomy reversal. This article reviews the impact of surgical skills, surgical approaches, intraoperative vasal fluid characteristics and the length of obstructive interval on VP. Based on the best available evidence, the rate of patency is related to the operative frequency of the surgeons, with better results obtained by surgeons who perform the operations at least 10 times annually. Microsurgical vasovasostomy is the preferred technique for durable good results. One-layer vasovasostomy and two-layer vasovasostomy seem to be equal with regard to VP. The rate of patency following vasovasostomy in the convoluted vas and vasovasostomy in the straight vas is comparable. The patency rate is high in men with clear intraoperative vasal fluid in at least one vas. VP is still high among patients with a long obstructive interval. In conclusion, surgical skills and intraoperative vasal fluid characteristics are the most important predictors of VP. Postoperative semen quality and the age of the female partner determine the chance of spontaneous conception in these couples.},
  author       = {Elzanaty, Saad and Dohle, Gert R},
  issn         = {1651-2065},
  language     = {eng},
  number       = {4},
  pages        = {241--246},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian journal of urology and nephrology},
  title        = {Vasovasostomy and predictors of vasal patency: A systematic review.},
  url          = {http://dx.doi.org/10.3109/00365599.2012.669790},
  volume       = {46},
  year         = {2012},
}