vasovasostomies การใช้

• Vasovasostomy can be effective regardless of how long it's been since the original vasectomy.
• This surgery is used when a vasovasostomy won't work because sperm flow is blocked.
• While in Australia in 1975, Silber performed the world s first microsurgical vasectomy reversal and popularized the microscopic vasovasostomy.
• Most urologists specializing in the field of male infertility perform vasovasostomies using an operative microscope for magnification, under general or regional anesthesia.
• In a recently published report 95 % of men with a vasovasostomy had motile sperm in the ejaculate within 1 year after vasectomy reversal.
• The failure of a competently performed microsurgical vasovasostomy following the absence of any sperm in the contents of each vas usually is due to  blowouts in the epididymides.
• Another issue to consider is the likelihood of vasoepididymostomy at the time of vasectomy reversal, as this technique is generally associated with lower patency and pregnancy rates than vasovasostomy.
• Higher success rates are found with reversal of vasovasostomy than those with a vasoepididymostomy, and factors such as antisperm antibodies and epididymal dysfunction are also implicated in success rates.
• The procedure involves a similar surgical incision as vasovasostomy; however, unlike with a vasovasostomy, the testis is usually delivered into the field for this more complex microsurgery.
• The procedure involves a similar surgical incision as vasovasostomy; however, unlike with a vasovasostomy, the testis is usually delivered into the field for this more complex microsurgery.
• There are however, no large randomised prospective controlled trials comparing patency or pregnancy rates following the decision to perform either microsurgical vasovasostomy to microsurgical vasoepididymosty as determined by this paradigm.
• If sperm were seen in one or both vas contents at the time of surgery, or sperm reached the patient s semen only transiently after the reversal, microsurgical vasovasostomy may be successful.
• If sperm are found at the testicular end of the vas deferens, then it is assumed that a secondary epididymal obstruction has not occurred and a vas deferens-to-vas deferens reconnection ( vasovasostomy ) is planned.
• Simple FNA maps are offered to those who are planning to have reconstructive procedures ( e . g ., vasovasostomy ) or sperm aspiration from the epididymis and who desire more complete information about spermatogenesis before proceeding with reconstruction or sperm retrieval.