The experiences of microsurgical refertilization in a single-centre study during a period of 27 years are presented.
Nearly 2000 patients were operated by a single surgeon (JUS). 1708 patients were evaluated in a data base, 1164 were available for a follow up. Both vasovasostomy (VV) and epididymovasostomy (EV) were carried out in a three layer technique. In the cases of Vasectomy reversal (VR) endtoend VV was only performed if spermatozoa had been demonstrated at the epididymal stump of the vas. In all other cases of VR, EV was done in a preocclusive region of the epididymal tubule. In the cases of postinfectious obstruction (PIO) of seminal pathways, always an EV was carried out. The outpatient procedure of refertilization was associated with a very low complication rate, which underlines its minimal invasive character. The followup rate was 68 %, the overall patency rate was 88 % for VR and 67 % for PIO and the pregnancy rate was 59% for VR and 38% for PIO. Secondary azoospermia was observed in 1% of the patients. In relation to the intervals of obstruction, the patency and pregnancy rates were higher after short-term obstruction than after longterm obstruction. There is a significant discrepancy between potency and pregnancy rates that is likely to be caused by a relevant number of patients with postoperative asthenozoospermia.
Schwarzer JU, Steinfatt H. Are you the author?
Andrologie Centrum Muenchen, nchen, Germany.
Reference: Minerva Urol Nefrol. 2014 Jul 24. Epub ahead of print.