Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Comparison of low-power magnification one-layer vasovasostomy with stent and microscopic two-layer vasovasostomy for vasectomy reversal

International Journal of Impotence Research volume 32, pages 617–622 (2020)Cite this article

Subjects

Abstract

This study aimed to evaluate a simplified vasovasostomy procedure that shortens the operative time. This was a retrospective (non-randomized) study of men who underwent bilateral vasectomy and consulted for vasovasostomy (02/2014-08/2016). Eight interrupted sutures were used for one-layer full-thickness vasal anastomosis over a 20 or 22 G catheter temporarily inserted in the lumen of the anastomotic site as a stent. Control patients underwent double-layer vasovasostomy. The surgery was significantly shorter in the one-layer group (n = 23) (62 ± 8 vs. 133 ± 15 min, P < 0.001 vs. the two-layer group, (n = 19)). There was no difference in patency between the two groups (95.7 vs. 94.7%, P > 0.999). There was one case of epididymitis in each group. There were no complications like bleeding, scrotal hematoma, hydrocele, or infection. Low-power microscopic one-layer vasovasostomy with stent was simple and had a short operation time. The patency could be similar to that of two-layer vasovasostomy, but prospective studies are necessary for confirmation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ostrowski KA, Holt SK, Haynes B, Davies BJ, Fuchs EF, Walsh TJ. Evaluation of vasectomy trends in the United States. Urology. 2018;118:76–79.

    Article  Google Scholar 

  2. Hamdy FC, Eardley I. Oxford textbook of urological surgery. New York: Oxford University Press; 2017.

    Book  Google Scholar 

  3. Cook LA, Pun A, Gallo MF, Lopez LM, Van Vliet HA. Scalpel versus no-scalpel incision for vasectomy. Cochrane Database Syst Rev. 2014;2014:CD004112.

  4. Zeng Y, Hesketh T. The effects of China’s universal two-child policy. Lancet. 2016;388:1930–8.

    Article  Google Scholar 

  5. Herrel L, Hsiao W. Microsurgical vasovasostomy. Asian J Androl. 2013;15:44–48. https://doi.org/10.1002/14651858.CD004112.pub4.

    Article  Google Scholar 

  6. Sandlow JI, Nagler HM. Vasectomy and vasectomy reversal: important issues. Preface. Urol Clin North Am. 2009;36:xiii–xiv.

    Article  Google Scholar 

  7. Silber SJ. Microsurgery in clinical urology. Urology. 1975;6:150–3.

    Article  CAS  Google Scholar 

  8. French DB, Sabanegh E. Advances in microsurgery and assisted reproduction for management of male infertility. Front Biosci. 2009;1:381–9.

    Google Scholar 

  9. Rimar K, Trost L, Brannigan RE. Vasovasostomy techniques for microsurgery specialists. In: Sandlow JI, (Ed.). Microsurgery for fertility specialists—a practical text. New York: Springer Science+Business Media; 2012.

    Google Scholar 

  10. Patel AP, Smith RP. Vasectomy reversal: a clinical update. Asian J Androl. 2016;18:365–71.

    Article  Google Scholar 

  11. Belker AM, Thomas AJ Jr., Fuchs EF, Konnak JW, Sharlip ID. Results of 1469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. J Urol. 1991;145:505–11.

    Article  CAS  Google Scholar 

  12. Goldstein M, Li PS, Matthews GJ. Microsurgical vasovasostomy: the microdot technique of precision suture placement. J Urol. 1998;159:188–90.

    Article  CAS  Google Scholar 

  13. Hernandez J, Sabanegh ES. Repeat vasectomy reversal after initial failure: overall results and predictors for success. J Urol. 1999;161:1153–6.

    Article  CAS  Google Scholar 

  14. Nalesnik JG, Sabanegh ES Jr. Vasovasostomy: multiple children and long-term pregnancy rates. Curr Surg. 2003;60:348–50.

    Article  Google Scholar 

  15. Marks SHF. Vasectomy reversal: manual of vasovasostomy and vasoepididymostomy. 1st ed. Cham, Switzerland: Springer Nature; 2019.

    Book  Google Scholar 

  16. Lee JY, Chang JS, Lee SH, Ham WS, Cho HJ, Yoo TK, et al. Efficacy of vasectomy reversal according to patency for the surgical treatment of postvasectomy pain syndrome. Int J Impot Res. 2012;24:202–5.

    Article  CAS  Google Scholar 

  17. Fischer MA, Grantmyre JE. Comparison of modified one- and two-layer microsurgical vasovasostomy. BJU Int. 2000;85:1085–8.

    Article  CAS  Google Scholar 

  18. Dickey RM, Pastuszak AW, Hakky TS, Chandrashekar A, Ramasamy R, Lipshultz LI. The evolution of vasectomy reversal. Curr Urol Rep. 2015;16:40.

    Article  Google Scholar 

  19. Nyame YA, Babbar P, Almassi N, Polackwich AS, Sabanegh E. Comparative cost-effectiveness analysis of modified 1-layer versus formal 2-layer vasovasostomy technique. J Urol. 2016;195:434–8.

    Article  Google Scholar 

  20. Herrel LA, Goodman M, Goldstein M, Hsiao W. Outcomes of microsurgical vasovasostomy for vasectomy reversal: a meta-analysis and systematic review. Urology. 2015;85:819–25.

    Article  Google Scholar 

  21. Hsieh ML, Huang HC, Chen Y, Huang ST, Chang PL. Loupe-assisted vs microsurgical technique for modified one-layer vasovasostomy: is the microsurgery really better? BJU Int. 2005;96:864–6.

    Article  Google Scholar 

  22. Jee SH, Hong YK. One-layer vasovasostomy: microsurgical versus loupe-assisted. Fertil Steril. 2010;94:2308–11.

    Article  Google Scholar 

  23. Shessel FS, Lynne CM, Politano VA. Use of exteriorized stents in vasovasostomy. Urology. 1981;17:163–5.

    Article  CAS  Google Scholar 

  24. Safarinejad MR, Lashkari MH, Asgari SA, Farshi A, Babaei AR. Comparison of macroscopic one-layer over number 1 nylon suture vasovasostomy with the standard two-layer microsurgical procedure. Hum Fertil. 2013;16:194–9.

    Article  Google Scholar 

  25. Vrijhof EJ, de Bruine A, Zwinderman A, Lycklama a Nijeholt AA, Koole L. New nonabsorbable stent versus a microsurgical procedure for vasectomy reversal: evaluating tissue reactions at the anastomosis in rabbits. Fertil Steril. 2005;84:743–8.

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by the 2015 Basic Research Project (Grant No. JCYJ20150403101028174) of Shenzhen Commission on Science and Technology Innovation and Sanming Project of Medicine in Shenzhen and the 2015 Engineering Center Project (Grant No. GCZX2015043016165448). The funding source(s) had no involvement in study design, collection, analysis, and interpretation of data, and writing of the report

Author information

Authors and Affiliations

  1. Department of Urology, Fujian Medical University Union Hospital, Fuzhou, China

    Bin Wang

  2. Department of Urology, ZhongShan Hospital Xiamen University, Xiamen, China

    Ziming Liu

  3. Department of Urology, Minimally Invasive Urology of Shenzhen Research and Development Center of Medical Engineering and Technology, Shenzhen People’s Hospital, Second Clinic Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, 518020, China

    Hongtao Jiang

Authors
  1. Bin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ziming Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hongtao Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BW and HJ conceived the study, participated in its design, and performed the surgical procedures and data acquisition. ZL drafted and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hongtao Jiang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, B., Liu, Z. & Jiang, H. Comparison of low-power magnification one-layer vasovasostomy with stent and microscopic two-layer vasovasostomy for vasectomy reversal. Int J Impot Res 32, 617–622 (2020). https://doi.org/10.1038/s41443-019-0216-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-019-0216-x

Search

Advanced search

Quick links