Vasectomy reversal: experience in Ramathibodi Hospital, Thailand

Autor: K, Ratana-olarn, P, Gojaseni, V, Muangman, V, Visethsin, W, Ariyaprakai, V, Visuthikosol
Rok vydání: 1982
Předmět:
Zdroj: Journal of the Medical Association of Thailand = Chotmaihet thangphaet. 65(5)
ISSN: 0125-2208
Popis: Vasectomy, as a fertility control measure, is appropriate for developing countries which face the problem of increasing population growth, such as Thailand. Vasectomy would be a much more attractive procedure if it could be easily reversed. Outcomes of vasectomy reversals using both conventional techniques and microsurgical methods are reported. From April 1973-January 1980, 34 vasectomy reversals were performed in Ramathibodi Hospital using conventional methods. 21 cases are available for analysis. Patient ages ranged from 25-51 years, with an average of 36.8 years. Vasectomies had been performed up to 17 years prior to reversal; in 14 cases, the procedures had taken place within the previous 10 years. The conventional method involved placing intravasal splints of nylon or other material and stitching the muscularis with interrupted sutures. Of the 21 cases, sperm reappearance was positive in 15 patients (71.4%) and pregnancy occurred in 11 cases (52.3%). The interval from reversal to pregnancy ranged from 2 to 12 months, and averaged 5.1 months. Of these patients whose vasectomies had been within the past 10 years, pregnancy occurred in 64.3%. For patients whose vasectomies had been performed more than 10 years prior to the reversal, only 28.5% achieved pregnancy. 16 vasectomy reversals using microsurgical techniques were performed from August 1978-January 1980 and 13 cases were available for analysis. The patients' ages ranged from 28-50 years with a mean of 38.7 years. In 6 cases, the vasectomy had been performed within the previous 10 years. The microscopic technique involved 2 layered anastomosis with 6 sutures in the mucosa and muscularis sutures for reinforcement. 9 of the 13 cases had sperm in the ejaculate and 4 achieved pregnancy. Sperm reappearance was 100% for patients whose vasectomies had been done within the previous 10 years, and 43% in the other cases. The average interval from reversal to pregnancy was 6.2 months. 1 case had postoperative epididymo-orchitis. The results of the microsurgical methods are encouraging and with more experience, the overall results of vasectomy reversal should be highly satisfactory. Special centers in selected hospitals should be developed where reversal using microsurgical methods can be performed by trained surgeons.
Databáze: OpenAIRE