Vasectomy and vasovasostomy

Counseling should precede vasectomy so that the husband and wife understand the psychological as well as the physiological aspects of the procedure. The vasectomy is done under local anesthesia (xylocaine without epinephrine) either in a hospital or in a doctors office. A spermogram should be administered in the sixth and tenth week after vasectomy. Possible surgical complications are pain infection hematoma epididymitis spermatic granuloma and spontaneous recanalization. Reversibility of vasectomy by vasovasotomy is now possible. The procedure includes 4 steps: (1) excision of scar tissue; (2) oblique section and reapproximation of ends; (3) entering of thread by intraluminary needle; (4) external suturing of ends. Results have improved through use of better suturing material (silk 6-0 and 7-0) and the dissection microscope. Three studies mentioned reported a success rate of 70%.