title: Angled vas cutter for vasovasostomy: technique and results.
abstract: OBJECTIVE
  To describe the technique and results of bilateral vasovasostomy using a 3-mm vas cutting forceps angled at 15° (catalog no. NHF-3.15; ASSI) for vasal transection.
  
  
  METHODS
  Retrospective chart review. Institutional review board approval was granted by Western Institutional Review Board.
  
  
  METHODS
  Single vasectomy reversal center.
  
  
  METHODS
  Men who underwent a bilateral vasovasostomy at a single institution by a single surgeon between 2001 and 2012 and had a minimum of one semen analysis postoperatively or a reported natural conception.
  
  
  METHODS
  Before September 14, 2010, a straight-edge vas cutter was used on all vasovasostomy connections; 375 men received a bilateral vasovasostomy and met follow-up criteria. Beginning on September 14, 2010, an angled cutter was used on all vasovasostomy patients, with 194 men meeting the exclusion criteria.
  
  
  METHODS
  A minimum of 1 × 10(6) sperm reported on a postoperative semen analysis, or a reported natural conception was used to establish patency.
  
  
  RESULTS
  The overall vasovasostomy patency rate using the angled vas cutter was 99.5% and was 95.7% using the straight vas cutter.
  
  
  CONCLUSIONS
  The development of an angled vas cutter provides an increased surface area for vasal wound healing to allow for larger tissue diameter for better healing, resulting in high patency rates after vasovasostomy.
authors.affiliation: Department of Urology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
authors.forename: Lindsey E
authors.initials: LE
authors.lastname: Crosnoe
authors.affiliation: Department of Urology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee. Electronic address: ekim@utmck.edu.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Kim
authors.affiliation: Arizona Andrology Laboratory & Cryobank, Tucson, Arizona.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Perkins
authors.affiliation: Arizona Andrology Laboratory & Cryobank, Tucson, Arizona.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Marks
authors.affiliation: Arizona Andrology Laboratory & Cryobank, Tucson, Arizona; International Center for Vasectomy Reversal, Tucson and Phoenix, Arizona; Department of Urology, University of Arizona College of Medicine, Tucson, Arizona.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Burrows
authors.affiliation: Arizona Andrology Laboratory & Cryobank, Tucson, Arizona; International Center for Vasectomy Reversal, Tucson and Phoenix, Arizona; Department of Urology, University of Arizona College of Medicine, Tucson, Arizona.
authors.forename: Sheldon H F
authors.initials: SH
authors.lastname: Marks
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D055101:Semen Analysis / Q000379:methods; D013076:Sperm Count / Q000379:methods; D013525:Surgical Instruments / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014649:Vas Deferens / Q000502:physiology / Q000601:surgery*; D014669:Vasovasostomy / Q000295:instrumentation* / Q000379:methods*
keywords: Vasovasostomy; patency