Comparison of macroscopic one-layer over number 1 nylon suture vasovasostomy with the standard two-layer microsurgical procedure

Abstract

Objective: To compare the outcomes of macroscopic one-layer vasovasostomy (MOLVV) with those of two-layer microsurgical vasovasostomy (TLMVV). Methods: Standard TLMVV was performed in 112 men (Group 1), while MOLVV was performed in 94 patients. All of the MOLVVs were performed with number 1 nylon suture as a temporary stent. The outcome measures were as follows: patency rate, pregnancy rate, operation time, total procedure cost, and complications. Results: The mean operation duration was 114 ± 10 min for the TLMVV technique, and 74 ± 5 min for the MOLVV procedure (P = 0.024). In patients who underwent vasal patency at 6-month postoperative period, the median sperm density (10⁶/mL) was 28.3 and 27.7 in Groups 1 and 2, respectively (P = 0.62). At the same time, the median total motile sperm count (× 10⁶) was 39.4 and 32.6 in two-layer microsurgical and one-layer macroscopic groups, respectively (P = 0.47). Patency rates were 82.1% in Group 1 and 77.7% in Group 2, which were not significantly different (P = 0.21). The pregnancy rate was 28.4% for patients in Group 1 and 26.7% for patients in Group 2 (P = 0.38). Conclusions: There were no significant differences in terms of patency and pregnancy rates between MOLVV and TLMVV methods, but the MOLVV technique offers a decreased cost and operative time, and a simplified procedure.

Keywords::

• Vasectomy reversal
• vasovasostomy
• microscopic
• patency
• pregnancy
• operation time
• postoperative vasal stricture

Acknowledgment

We thank Parisa Khoddam for drawing the figures. The authors are grateful to Saba Safarinejad for her cooperation in statistical analysis. We also thank Nayyer Shafiei and Shiva Safarinejad for their valuable contributions.

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.