title: Loupe-assisted vs microsurgical technique for modified one-layer vasovasostomy: is the microsurgery really better?
abstract: OBJECTIVE
  To compare the outcome of loupe-assisted, modified one-layer vasovasostomy (MOLV) and conventional microsurgical MOLV for vasectomy reversal.
  
  
  METHODS
  We retrospectively analysed data for 74 patients who had a MOLV between 1993 and 2003; 42 had the standard microsurgical (x10-16) MOLV (group 1, mean age 40.5 years, SD 6.3, range 30-58) and 32 a loupe-assisted (x 3) MOLV (group 2, mean age 41.3 years, SD 6, range 28-64). With general anaesthesia, each operation was performed as an outpatient procedure or with hospitalization for one night after surgery. The patients' characteristics, patency rate, paternity rate, and operative duration were compared.
  
  
  RESULTS
  The mean (SD, range) duration of obstruction was 8.1 (5.0, 0.33-25) years in group 1 and 9.2 (4.8, 0.33-27) years in group 2. The postoperative patency and pregnancy rates were 91% and 43% for group 1 and 89% and 39% for group 2. There were no complications during or after surgery in either group, but the surgery was significantly faster for group 2.
  
  
  CONCLUSIONS
  There was no significant difference in the patency and paternity rates between loupe-assisted and microsurgical MOLV. The surgery was significantly faster with the loupe-assisted method. Because of the shorter operation duration and less expensive instruments required that should reduce the cost, the loupe-assisted MOLV should be considered as the best choice for simple vasectomy reversal.
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan. h0810@adm.cgmh.com.tw
authors.forename: Ming-Li
authors.initials: ML
authors.lastname: Hsieh
authors.forename: Hsin Chieh
authors.initials: HC
authors.lastname: Huang
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Shih Tsung
authors.initials: ST
authors.lastname: Huang
authors.forename: Phei Lang
authors.initials: PL
authors.lastname: Chang
mesh_terms: D000328:Adult; D005298:Fertility / Q000502:physiology; D006801:Humans; D007902:Length of Stay; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014669:Vasovasostomy / Q000379:methods*