Techniques and results of microsurgical vasectomy reversal.

Results of 42 consecutive vasectomy reversals are reported. Postoperative sperm concentrations are reviewed and reasons for postoperative azoospermia in 12% (5 of 42 patients) appear to be related to adverse physiologic consequences of vasectomy in these patients rather than to failure of the anastomosis. Of 38 patients eligible for conception pregnancy occurred in 23 (60%) of their wives. An additional 7 (17%) of the 42 patients including all 4 not currently eligible for conception had normal postoperative sperm concentrations and motility. Therefore even higher pregnancy rates in the wives of all 42 patients are anticipated as further time elapses. These results compare favorably with those reported by others. Anastomotic techniques are shown and factors influencing decisions concerning performance of simple vasovasostomy (vas anastomosis) or the more complicated bypass vasoepididymostomy are discussed. (authors)