A Review of the Literature and a Report of Nine New Cases

Vasovasostomy: evaluation of success

Our review of 2,685 cases of vasovasostomy reported between 1948 and 1977 shows that many different surgical techniques can be successful. However, various reporting practices have made case comparisons difficult. We suggest a standardized method for reporting vasovasostomy results.

Recanalisation of vas after vasectomy. Evaluation of various techniques in dogs

A critical study of various techniques for end-to-end vaso-vasostomies without or with internal splints on 41 dogs is presented. The results of vaso-vasostomy without any internal splint were significantly better than those with splints, both for primary as well as secondary repair after 6 weeks. The presence of an internal splint was associated with a high incidence of severe infection in the vas, epididymis and testis. An end-to-end mucosa-to-mucosa anastomosis using either 6/0 silk or Prolene under magnification is recommended as a simple and successful methods of recanalisation of the vas in clinical practice.

Vasovasostomy. Experimental comparative study of polyglycolic acid and polypropylene sutures in the dog

Experimental vasovasostomy in dogs using polyethylene tubing for splints and comparing polyglycolic acid to polypropylene sutures demonstrates the following: Polyglycolic acid sutures result in a higher vasovasostomy patency rate. Grossly and microscopically, polyglycolic acid sutures are associated with less vasal and perivasal fibrosis. Postoperative use of very small polyethylene tubing for splints appears feasible. Leaving splints entirely intraluminally at the time of surgery may be advantageous. It would necessitate vasotomy for removal of the splint postoperatively, but this is easily accomplished and not associated with increased morbidity. A transscrotal approach is associated with a much higher vasal patency rate than is an inguinal approach.

Psychological aspects of vasectomy

In a study to assess the psychosocial and sexual effects of contraceptive vasectomy by questionnaire and personal interview, 10 out of 82 respondents indicated some psychological problem arising from the operation. Five out of seven couples interviewed had histories of marital, sexual, or psychological instability. Screening of applicants for vasectomy is therefore recommended, pre-existing instability being a contraindication to the operation.