Techniques in urology – Tension-relieving microdot vasovasostomies and longitudinal intussuscepted vasoepididymostomy vasectomy reversals

A first report

Authors

  • Abdullah Alhamam University of British Columbia
  • Kiera Liblik School of Medicine Queen's University, Kingston, ON, Canada.
  • Luke Witherspoon Department of Urology, University of Ottawa. Ottawa, ON, Canada.
  • Adam Dorner Faculty of Medicine, The University of British Columbia, Vancouver, Canada
  • Ryan Flannigan Department of Urologic Sciences, The University of British Columbia, Vancouver, Canada.

DOI:

https://doi.org/10.5489/cuaj.8899

Keywords:

Vasectomy reversal VR, Vasovasostomy VV, vasoepididymostomy VE, Patency, tension-relieving sutures

Abstract

INTRODUCTION: Tension and malalignment of vasectomy reversal (VR) anastomoses are hypothesized to contribute to failure. We report VR outcomes using a novel technique introducing a tension-reliving hitch in the multilayer microdot vasovasostomy (VV) and longitudinal intussuscepted vasoepididymostomy (LIVE; VE).

METHODS: All VR patients between May 2019 and September 2023 from a single surgeon were reviewed. Patients were included if they underwent a VR with at least one semen analysis within six months of surgery and a minimum of six months of followup after the surgery to deem a failure. The primary outcome was patency, which was defined as 1) any sperm in the ejaculate; and 2) functionally as at least two million motile sperm. Late failure was defined as an azoospermic semen analysis result after previously documented presence of sperm.

RESULTS: A total of 159 patients were evaluated, of which 136 patients met the inclusion criteria. The patency rate among all VRs was 97.7 %, with an overall functional patency rate of 93.1%. One hundred and one patients underwent bilateral VVs, with a 99% patency rate and 95.5% functional patency rate. Twenty-three patients underwent a mixed VV/VE, with a patency rate of 100% and a functional patency rate of 88.8%. Finally, 12 patients underwent bilateral VE, with a patency rate of 83.3% and a functional patency rate of 77.7%. Among these patients, four VV patients were identified to have a late failure.

CONCLUSIONS: The combination of tension-relieving stitches for VVs and VEs, along with attention to symmetrical and precise stitch placement, results in high patency rates.

Downloads

Download data is not yet available.

Downloads

Published

2024-11-04

How to Cite

Alhamam, A., Liblik, K. . ., Witherspoon , L. ., Dorner, A. ., & Flannigan , R. . (2024). Techniques in urology – Tension-relieving microdot vasovasostomies and longitudinal intussuscepted vasoepididymostomy vasectomy reversals: A first report. Canadian Urological Association Journal, 19(3), E114–8. https://doi.org/10.5489/cuaj.8899

Issue

Vol. 19 No. 3 (2025): CUAJ March

Section

Techniques in urology

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.