[Success rates of two-layer, microsurgical vasovasostomy. Results from a patient questionnaire and comparison with one-layer technique].
Vasovasostomy is the most commonly performed procedures in the therapy for occlusive azoospermia after vasectomy. In our clinic the two-layer microsurgical technique (DL VVST) is considered to be the gold standard. We have examined the results of DL VVST by means of a questionnaire and compared them with those of the monolayer technique (ML VVST).


METHODS
In the period from 1996 to 2001, a microsurgical DL VVST with 10 x 0 Prolene sutures under the operation microscope was performed in 141 patient. Aspects of the operation, social aspects and postoperative results (results of spermiogram, birth rates) were assessed by means of a questionnaire. The results were compared with those of a historical patient collective who had undergone a modified monolayer VVST with 7 x 0 Prolene (n = 64).


RESULTS
The questionnaire could be sent to 90/141 patients, the response rate was 63/90 (70 %). The time interval between vasectomy and VVST was on average 9.5 years. The patency rate was 86 %, the birth rate 24 %. Severe or moderately sever complications did not occur. In the historical patient collective, the average occlusion interval was 6.9 years. The patency rate in these patients in whom the VVST was performed merely under the loupe and in a monolayer technique was 87 %, the pregnancy rate 48 %.


CONCLUSIONS
The highly positive results of VVST with pregnancy rates > 80 % from earlier publications could not be reproduced. According to our results, the two-layer VVST does not afford better results than the monolayer technique.
Friedrich
M G
MG
Klinik und Poliklinik für Urologie, Universität Hamburg, Universitätsklinikum Hamburg Eppendorf, Hamburg. friedrich@uke.uni-hamburg.de
Friedrich
E
E
Graefen
M
M
Heinzer
H
H
Michl
U
U
Huland
H
H
Noldus
J
J
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009845:Oligospermia / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D011247:Pregnancy; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D014659:Vasectomy; D014669:Vasovasostomy / Q000379:methods*