A New Method of Two Layer Vasovasostomy / 대한비뇨기과학회지

ABSTRACT

The frequency with which vasovasostomy is performed has increased dramatically because a significant percentage of the millions of men who underwent vasectomy in the last decade are now seeking to regain their fertility. Considerable controversy exists regarding the most effective surgical method. The Silber`s two layer anastomosis technique is the best one until now, but that is a time consuming procedure and difficult in a beginner, and all of the knots are should be placed just outside of the mucosa. In an attempt to develop an easier and faster and less complicated method of performing two layer microsurgical vasovasostomy, we developed a new operating method of two layer anastomosis. Thenkey points of the new technique is that an anastomosis is completed with a double wedged 9-0 nylon suture for one suture by one time, continuously. All of the knots are placed outside of the vas. The new two-layer microsurgical anastomosis was used starting in 1994. We have used this method in 15 patients. Average skin to skin operation time is two and half and three hours. Sperm count was normal limits in 10 patients after 6 months after operation, in 2 patients between 3 weeks and 3 months after operation, oligospermia in 2 patients and azoospermia was in 1 patient 6 months after operation. We conclude this method is a good one, since the new two-layer technique is easier, faster, less complicated than original two-layer anastomosis, although this is a early results and describes the initial experience with this new microsurgical technique.