116 results match your criteria Vasovasostomy and Vasoepididymostomy


Vasectomy and vasectomy reversal: a comprehensive approach to the evolving spectrum of care.

Fertil Steril 2021 Jun;115(6):1363-1364

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address:

Male reproduction and male contraception form an important spectrum within men's health. In this issue's Views and Reviews, four author groups detail important new developments in vasectomy clinical practice guidelines, emerging and investigational techniques in the fields of hormonal and nonhormonal male contraception, useful paradigms for patient care when deciding between sperm extraction with in vitro fertilization and vasectomy reversal, and finally, a state-of-the-art overview of recent developments in vasectomy reversal microsurgery. These articles will provide readers with a contemporary understanding of the rapidly evolving spectrum of male reproductive and contraceptive health care. Read More

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Impact of surgical volume and resident involvement on patency rates after vasectomy reversal-A 14-year experience in an open access system.

Asian J Urol 2021 Apr 23;8(2):197-203. Epub 2020 Apr 23.

Division of Urology, Duke University Hospital, Durham, NC, USA.

Objective: Evaluate the influence of fellowship training, resident participation, reconstruction type, and patient factors on outcomes after vasectomy reversals in a high volume, open access system.

Methods: Retrospective review of all vasectomy reversals performed at a single institution from January 1, 2002 to December 31, 2016 was conducted. Patient and spouse demographics, patient tobacco use and comorbidities, surgeon training and case volume, resident participation, reconstruction type, and postoperative patency were collected and analyzed. Read More

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Vasovasostomy and vasoepididymostomy: indications, operative technique, and outcomes.

Fertil Steril 2021 Jun 27;115(6):1384-1392. Epub 2021 Apr 27.

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address:

The basic principles of vasal reconstruction have endured since their initial description over a century ago, yet the nuances and technical approaches have evolved. Prior to performing vasectomy reversal, the clinician should perform a focused history, physical and laboratory assessment, all of which are critical for patient counseling and preoperative planning. Operative success is contingent on appropriate intraoperative decision making and technical precision in completing a tension-free, watertight, and patent anastomosis. Read More

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Challenges in completing a successful vasectomy reversal.

Andrologia 2021 Jul 18;53(6):e14066. Epub 2021 Apr 18.

Department of Urology, University of Miami, Miami, FL, USA.

Although a wide array of interventions exist for men seeking fertility after vasectomy, up to 6% of them will elect for a vasectomy reversal. While the widespread adoption of telemedicine promises convenience and improved access, lack of ability to do a physical examination may hinder appropriate counselling. Although vasectomy reversal is successfully completed in most of the men either with a vasovasostomy or a vasoepididymostomy, there could be various reasons for the inability to successfully complete the operation. Read More

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3D digital image microscope system-assisted vasovasostomy and vasoepididymostomy in rats.

Asian J Androl 2021 Feb 9. Epub 2021 Feb 9.

Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.

Optimal vision and ergonomics are essential factors contributing to the achievement of good results during microsurgery. The three-dimensional (3D) digital image microscope system with a better 3D depth of field can release strain on the surgeon's neck and back, which can improve outcomes in microsurgery. We report a randomized prospective study of vasoepididymostomy and vasovasostomy using a 3D digital image microscope system (3D-DIM) in rats. Read More

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February 2021

Microsurgical seminal reconstruction; our experiences in a single institute.

Nagoya J Med Sci 2020 Aug;82(3):477-485

Asada Ladies Clinic, Nagoya, Japan.

We assessed the contribution of microsurgical seminal reconstruction to achieving natural conception in conjunction with advanced assisted reproductive technologies. Ninety obstructive azoospermic subjects who underwent microsurgical seminal reconstruction were evaluated. Vasovasostomy (VV) was undertaken in 45 subjects whereas vasoepididymostomy (VE) in 45, respectively. Read More

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Robot-assisted vasovasostomy and vasoepididymostomy: Current status and review of the literature.

Turk J Urol 2020 Sep 1;46(5):329-334. Epub 2020 Sep 1.

Department of Urology, SLK-Kliniken Heilbronn, University of Heidelberg, Heilbronn, Germany.

Objective: Microscope-assisted vasovasostomy (MAVV) is a standard procedure used to reverse vasectomies. Robotic surgery has been established primarily for technically demanding urological procedures and has also been recently implemented in male reproductive surgery. We aimed to review the current evidence of robot-assisted vasovasostomy (RAVV) and robot-assisted vasoepididymostomy (RAVE). Read More

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September 2020

[45 years of microsurgery in urology : Contemporary witnesses report with special reference to vasectomy reversal].

Authors:
Horst Oesterwitz

Urologe A 2020 Dec;59(12):1523-1540

Zentrum für Refertilisierungschirurgie, Klinik für Urologie, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467, Potsdam, Deutschland.

On the occasion of the 45th anniversary of the introduction of microsurgery in urology, the author describes the historical development of urologic microsurgery in Germany, with special reference to vasectomy reversal. Together with contemporary witnesses, a critical historical review is drawn and the current status is analyzed as well as an outlook is given. Read More

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December 2020

The effect of trainee involvement on surgical outcomes and complications of male infertility surgical procedures.

Andrologia 2020 Oct 19;52(9):e13719. Epub 2020 Jun 19.

Institute of Urology, University of Southern California, Los Angeles, CA, USA.

In this study, we sought to determine the effect of trainee (resident or fellow physician) involvement in male infertility surgical procedures on patient surgical outcomes and complications. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was retrospectively reviewed for fertility surgical procedures from 2006 to 2012. The procedures included were as follows: epididymectomy, spermatocelectomy, varicocelectomy ± hernia repair, ejaculatory duct resection, vasovasostomy, vasoepididymostomy and 'unlisted procedure male genital system' (to capture sperm retrieval procedures). Read More

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October 2020

Prednisone after vasectomy reversal may improve semen parameters: one institution's experience.

Can J Urol 2020 04;27(2):10181-10184

Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Introduction: Patients with suboptimal semen parameters following vasectomy reversal represent a diagnostic and therapeutic challenge. This may be caused by either partial or complete anastomotic obstruction. Despite the relatively common clinical use of corticosteroids in this patient population, data remain sparse. Read More

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Clinical application of cross microsurgical vasovasostomy in scrotum for atypical obstructive azoospermia.

J Zhejiang Univ Sci B 2019 Mar.;20(3):282-286

Department of Reproductive Endocrinology, Reproductive Medicine Center, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.

Seminal duct obstruction may result in obstructive azoospermia (OA) and severe oligoasthenoteratozoospermia (OAT) (<0.5 million/mL) (Nordhoff et al., 2015). Read More

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Microsurgical vasectomy reversal: contemporary techniques, intraoperative decision making, and surgical training for the next generation.

Fertil Steril 2019 03;111(3):444-453

Center for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, New York. Electronic address:

Men seeking fertility after elective sterilization can be treated with a wide array of interventions. Reconstruction of the reproductive tract remains the gold standard and most cost-effective option for the appropriately selected candidate. In the following review, the treatment algorithm for men desiring vasectomy reversal is outlined. Read More

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[Retrospective analysis of factors affecting patency rates and causes of failure in use of single-armed two-suture microsurgical vasoepididymostomy].

Zhonghua Yi Xue Za Zhi 2018 Dec;98(46):3741-3745

Department of Andrology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.

To analyze the factors affecting the patency rate of microsurgical single-stitch longitudinal intussusception vasoepididymostomy and to explore the possible causes of failure. The clinical data of 87 patients with epididymal obstructive azoospermia who underwent microsurgical vasoepididymostomy from January 2015 to February 2018 in the First Affiliated Hospital of Fujian Medical University were analyzed retrospectively. We observed the patency rate postoperatively and evaluated several factors that possibly related to the patency rates. Read More

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December 2018

Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade.

Reprod Med Biol 2018 Oct 22;17(4):343-355. Epub 2018 May 22.

Department of Urology Graduate School of Medicine Chiba University Chiba Japan.

Background: In the era of improving assisted reproductive technology (ART), patients with obstructive azoospermia (OA) have 2 options: vasal repair or testicular sperm extraction with intracytoplasmic sperm injection. Vasal repair, including vasovasostomy (VV) and vasoepididymostomy (VE), is the only option that leads to natural conception.

Methods: This article reviews the surgical techniques, outcomes, and predictors of postoperative patency and pregnancy, with a focus on articles that have reported over the last 10 years, using PubMed database searches. Read More

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October 2018

[Microsurgical management of obstructive azoospermia: Progress and prospects].

Zhonghua Nan Ke Xue 2018 Jul;24(7):579-288

Center for Male Reproductive Medicine and Microsurgery, Department of Urology, Cornell Institute for Reproductive Medicine, Weill Cornell Medicine of Cornell University, New York Presbyterian University Hospitals for Columbia and Cornell, New York, NY 10065, USA.

In the past two decades, with the rapid development of assisted reproductive technology and particularly the technological advances in male infertility microsurgery, many obstructive azoospermia-related infertile couples can now acquire the chances of natural pregnancy via reconstruction of the seminal tract. This article highlights the latest advances in surgical reconstruction of the seminal tract for the treatment of obstructive azoospermia, such as the application of laparoscopic and robotic techniques, with a discussion on microsurgical epididymal sperm aspiration and preservation, potential use of absorbable sutures or the bio-suture tape for microsurgical anastomosis in the management of obstructive azoospermia. Read More

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The Kinetics of Sperm Return and Late Failure Following Vasovasostomy or Vasoepididymostomy: A Systematic Review.

J Urol 2019 02;201(2):241-250

Center for Male Reproductive Medicine and Microsurgery, Cornell Institute for Reproductive Medicine, Department of Urology, Weill Cornell Medicine, New York, New York.

Purpose: Vasovasostomy and vasoepididymostomy are technically challenging microsurgical reconstructive procedures necessary for men with obstructive azoospermia at the level of the vas deferens or epididymis. Patency rates following vasovasostomy or vasoepididymostomy have been widely described in the literature. However, few reports have discussed the timing of sperm return to the ejaculate after reconstruction as well as the proportion of men in whom late failure develops following vasovasostomy or vasoepididymostomy. Read More

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February 2019

Reconsidering vasectomy reversal over assisted reproduction in older couples.

Fertil Steril 2018 06;109(6):1020-1024

Department of Urology, University of Washington, Seattle, Washington.

Objective: To provide pregnancy and live birth rates from a contemporary series of vasectomy reversals in men with female partners aged ≥35 years and to correlate the results with IVF.

Setting: Tertiary academic referral center.

Design: Retrospective comparative study of prospectively collected database. Read More

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Review of the role of robotic surgery in male infertility.

Arab J Urol 2018 Mar 13;16(1):148-156. Epub 2017 Dec 13.

The Personalized Urology and Robotics (PUR) Clinic, South Lake Hospital, Clermont, FL, USA.

Objectives: To present the current state of the art in various robot-assisted microsurgical procedures in male infertility and review the latest literature, as the technology in infertility procedures has substantially developed since the incorporation of the Vinci® robotic platform (Intuitive Surgical, Inc., Sunnyvale, CA, USA).

Materials And Methods: The search strategy in this review was conducted in accordance with Cochrane guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Read More

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Factors and practice patterns that affect the decision for vasoepididymostomy.

Can J Urol 2017 Feb;24(1):8651-8655

Department of Urology, Oregon Health & Science University, Portland, Oregon, USA.

Introduction: To determine the factors used to make the decision between vasovasostomy (VV) and vasoepididymostomy (VE) by leaders performing microsurgical vasectomy reversal using a questionnaire.

Materials And Methods: An online questionnaire was sent to all members of the Society for the Study of Male Reproduction (SSMR), a male reproduction subspecialty society of the AUA, using the SurveyMonkey platform.

Results: Sixty-seven surgeons responded to the questionnaire (27% of SSMR members). Read More

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February 2017

[Effectiveness of microsurgical crossover anastomosis in treating complicated obstructive azoospermia].

Zhonghua Yi Xue Za Zhi 2016 Sep;96(36):2868-2871

Department of Andrology and Pelvic Floor Surgery, Urologic Medical Center, Center for Men's Health, Institute of Urology, Shanghai General Hospital, Shanghai Key Lab of Reproductive Medicine, Shanghai Jiaotong University, Shanghai 200080, China.

To evaluate the efficacy and safety of microsurgical crossover vasovasostomy in treating complicated obstructive azoospermia. The data of 14 patients with complicated obstructive azoospermia treated with microsurgical crossover vasovasostomy were reviewed from October 2012 to March 2016.Ten of them underwent microsurgical crossover vasovasostomy. Read More

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September 2016

Vasectomy reversal: a clinical update.

Asian J Androl 2016 May-Jun;18(3):365-71

Department of Urology, University of Virginia, Charlottesville, VA 22908-0422, USA.

Vasectomy is a safe and effective method of contraception used by 42-60 million men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Read More

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January 2017

Pre-operative risk factors associated with need for vasoepididymostomy at the time of vasectomy reversal.

Andrology 2016 Jan 11;4(1):160-2. Epub 2015 Dec 11.

Department of Urology, Oregon Health & Sciences University, Portland, OR, USA.

The absence of sperm in the ejaculate after vasectomy reversal is commonly caused by failure to recognize and subsequently bypass epididymal or proximal vasal obstruction at the time of vasectomy reversal. If intra-operative proximal obstruction is suspected, vasoepididymostomy (VE) is recommended rather than vasovasostomy (VV). We sought to calculate the associated risk of needing VE, rather than VV with time from original vasectomy (obstructive interval) using a large cohort of vasectomy reversal patients. Read More

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January 2016

The evolution of vasectomy reversal.

Curr Urol Rep 2015 Jun;16(6):40

Baylor College of Medicine, Houston, TX, USA,

In the USA, about 500,000 vasectomies are performed each year, with up to 6% of men requesting reversal. The technique of vasectomy reversal has evolved from macrosurgical to the implementation of both microscopic and robotic technologies. The very earliest attempts at vasectomy reversal, the vasoepididymostomy and vasovasostomy, have remained central in the treatment of male infertility and will continue to be so for years to come. Read More

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[Microsurgical treatment of obstructive azoospermia: a report of 76 cases].

Zhonghua Nan Ke Xue 2015 Mar;21(3):239-44

Objective: To investigate the clinical effect of microsurgical vasoepididymostomy and/or vasovasostomy in the treatment of obstructive azoospermia.

Methods: This study included 76 patients with obstructive azoospermia, 53 treated by bilateral vasoepididymostomy (8 involving the epididymal head, 18 involving the epididymal body, 5 involving the epididymal tail, and 22 involving the epididymal head, body and tail), 14 by unilateral vasoepididymostomy, and the other 9 by unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis). We followed up the patients for 2 to 16 months for the patency rate, routine semen parameters, and pregnancy outcomes. Read More

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Multiple advanced surgical techniques to treat acquired seminal duct obstruction.

Asian J Androl 2014 Nov-Dec;16(6):912-6

Department of Urology, Shenzhen People's Hospital, Shenzhen 518020, China.

The aim of this study was to evaluate the outcomes of multiple advanced surgical treatments (i.e. microsurgery, laparoscopic surgery and endoscopic surgery) for acquired obstructive azoospermia. Read More

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Contemporary outcomes of seminal tract re-anastomoses for obstructive azoospermia: a nationwide Japanese survey.

Int J Urol 2015 Feb 23;22(2):213-8. Epub 2014 Sep 23.

Department of Urology and Andrology, Kansai Medical University, Osaka, Japan.

Objectives: To evaluate current outcomes of seminal tract re-anastomoses in Japan, and to compare them with historical data.

Methods: A total of 213 patients with obstructive azoospermia who underwent seminal tract re-anastomosis from April 2008 to March 2012 at 25 institutions were enrolled in the present study. The outcomes of the procedure were compared with those reported in a previous multi-institutional study carried out in 2000. Read More

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February 2015

Review of Azoospermia.

Spermatogenesis 2014 31;4:e28218. Epub 2014 Mar 31.

Department of Urology and Institute for Reproductive Medicine; Weill Cornell Medical College of Cornell University; New York, NY USA ; Director of the Center for Male Reproductive Medicine and Microsurgery; Weill Cornell Medical College of Cornell University; New York, NY USA ; Center for Biomedical Research; The Population Council; New York, NY, USA.

Azoospermia is classified as obstructive azoospermia (OA) or non-obstructive azoospermia (NOA), each having very different etiologies and treatments. The etiology, diagnosis, and management of azoospermia were reviewed and relevant literature summarized. Differentiation between these two etiologies is of paramount importance and is contingent upon thorough history and physical examination and indicated laboratory/genetic testing. Read More

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Higher outcomes of vasectomy reversal in men with the same female partner as before vasectomy.

J Urol 2015 Jan 1;193(1):245-7. Epub 2014 Aug 1.

Department of Urology, Oregon Health and Science University, Portland, Oregon.

Purpose: We reviewed fertility outcomes of vasectomy reversal at a high surgical volume center in men with the same female partner as before vasectomy.

Materials And Methods: We retrospectively studied a prospective database. All vasectomy reversals were performed by a single surgeon (EFF). Read More

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January 2015

MRI of the epididymis: can the outcome of vasectomy reversal be predicted preoperatively?

AJR Am J Roentgenol 2014 Jul;203(1):91-8

1 Department of Radiology, University of California, San Diego, San Diego, CA 92161.

Objective: The purpose of this study is to describe the MRI findings seen with tubular ectasia of the epididymis and investigate whether MRI may predict vasal/epididymal tubular occlusion before vasectomy reversal.

Materials And Methods: First, we compared epididymal T1 signal intensity (measured as percentage change relative to ipsilateral testis) in 24 patients with sonographically established tubular ectasia compared with 22 control patients (sonographically normal epididymides). Second, in a subset of patients with tubular ectasia who subsequently underwent surgery to restore fertility (n = 10), we examined the relationship between epididymal T1 signal intensity and surgical outcome. Read More

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Comparison of different autogenous graft materials for reconstruction of large segment vas deferens defect: experimental study in rat.

Urol J 2014 May 6;11(2):1457-64. Epub 2014 May 6.

Department of Pathology, Süleyman Demirel University, School of Medicine, Isparta, Turkey.

Purpose: Vasectomy is one of the most common urological operations performed, and provides permanent contraception. Many vasectomized men ultimately seek vasectomy reversal because of unforeseen changes in lifestyle. Vasovasostomy has varying rates of success. Read More

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