Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade
Abstract 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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-10-01
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| Series: | Reproductive Medicine and Biology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rmb2.12207 |
| _version_ | 1819176942706884608 |
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| author | Takeshi Namekawa Takashi Imamoto Mayuko Kato Akira Komiya Tomohiko Ichikawa |
| author_facet | Takeshi Namekawa Takashi Imamoto Mayuko Kato Akira Komiya Tomohiko Ichikawa |
| author_sort | Takeshi Namekawa |
| collection | DOAJ |
| description | Abstract 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. Main findings The reported mean patency rate was 87% and the mean pregnancy rate was 49% for a patient following microscopic VV and/or VE for vasectomy reversal. Recently, robot‐assisted techniques were introduced and have achieved a high rate of success. The predictors and predictive models of postoperative patency and pregnancy also have been reported. The obstructive interval, presence of a granuloma, and intraoperative sperm findings predict postoperative patency. These factors also predict postoperative fertility. In addition, the female partner's age and the same female partner correlate with pregnancy after surgery. Conclusion In the era of ART, the physician should present and discuss with both the patient with OA and his partner the most appropriate procedure to conceive by using these predictors. |
| first_indexed | 2024-12-22T21:18:47Z |
| format | Article |
| id | doaj.art-0d8bdbc9af404112a9d8791860d1436b |
| institution | Directory Open Access Journal |
| issn | 1445-5781 1447-0578 |
| language | English |
| last_indexed | 2024-12-22T21:18:47Z |
| publishDate | 2018-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Reproductive Medicine and Biology |
| spelling | doaj.art-0d8bdbc9af404112a9d8791860d1436b2022-12-21T18:12:15ZengWileyReproductive Medicine and Biology1445-57811447-05782018-10-0117434335510.1002/rmb2.12207Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decadeTakeshi Namekawa0Takashi Imamoto1Mayuko Kato2Akira Komiya3Tomohiko Ichikawa4Department of Urology Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology Graduate School of Medicine Chiba University Chiba JapanDepartment of Urology Graduate School of Medicine Chiba University Chiba JapanAbstract 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. Main findings The reported mean patency rate was 87% and the mean pregnancy rate was 49% for a patient following microscopic VV and/or VE for vasectomy reversal. Recently, robot‐assisted techniques were introduced and have achieved a high rate of success. The predictors and predictive models of postoperative patency and pregnancy also have been reported. The obstructive interval, presence of a granuloma, and intraoperative sperm findings predict postoperative patency. These factors also predict postoperative fertility. In addition, the female partner's age and the same female partner correlate with pregnancy after surgery. Conclusion In the era of ART, the physician should present and discuss with both the patient with OA and his partner the most appropriate procedure to conceive by using these predictors.https://doi.org/10.1002/rmb2.12207male infertilityobstructive azoospermiavasectomy reversalvasoepididymostomyvasovasostomy |
| spellingShingle | Takeshi Namekawa Takashi Imamoto Mayuko Kato Akira Komiya Tomohiko Ichikawa Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade Reproductive Medicine and Biology male infertility obstructive azoospermia vasectomy reversal vasoepididymostomy vasovasostomy |
| title | Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade |
| title_full | Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade |
| title_fullStr | Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade |
| title_full_unstemmed | Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade |
| title_short | Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade |
| title_sort | vasovasostomy and vasoepididymostomy review of the procedures outcomes and predictors of patency and pregnancy over the last decade |
| topic | male infertility obstructive azoospermia vasectomy reversal vasoepididymostomy vasovasostomy |
| url | https://doi.org/10.1002/rmb2.12207 |
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