Gopi S S, Townell N H
Department of Urology, Tayside University Hospitals NHS Trust, Ninewells Hospital, Dundee DD1 9SY, UK.
Scott Med J. 2007 May;52(2):18-20. doi: 10.1258/rsmsmj.52.2.18.
To evaluate the outcomes of bilateral vasectomy reversal procedure in relation to the macroscopic technique, surgical time and duration of obstructive interval.
We performed a retrospective study over a twelve-year period using a macroscopic technique. All cases of vasectomy reversal were consecutive and performed by the same surgeon. The procedure was performed using a single layer, spatulate end to end anastomosis technique using 6 x 6-0 prolene. No loupe magnification was used.
The median age of the men was 42 years (range 30-56). The median obstructive interval in years was 8.5 years (range 2-23). The procedure was a day case and the median surgical time under general anaesthetic was 75 minutes (range 45-90). None of the patients required hospital admission following discharge. 63 of the 70 patients had positive patency test postoperatively (90%). The sperm count was more than twenty million/ml. The pregnancy rate was 54% and the miscarriage rate was 7.1%.
The outcomes of macroscopic vasectomy reversal performed by an experienced surgeon can have a high success rate using the macroscopic single layer spatulate end to end anastomosis technique. This technique is easy to learn compared to the learning curve involved in microsurgery and is an effective means of "re- establishing" fertility in vasectomised men.
评估双侧输精管复通术的效果，该效果与宏观技术、手术时间及梗阻间隔时间相关。
我们采用宏观技术进行了一项为期12年的回顾性研究。所有输精管复通病例均为连续病例，且由同一位外科医生实施手术。手术采用单层、铲形端对端吻合技术，使用6-0聚丙烯缝线。未使用放大镜放大。
男性患者的中位年龄为42岁（范围30 - 56岁）。梗阻间隔时间的中位数为8.5年（范围2 - 23年）。该手术为日间手术，全身麻醉下的中位手术时间为75分钟（范围45 - 90分钟）。所有患者出院后均无需住院。70例患者中有63例术后通畅试验呈阳性（90%）。精子计数超过2000万/毫升。妊娠率为54%，流产率为7.1%。
经验丰富的外科医生采用宏观输精管复通术，运用宏观单层铲形端对端吻合技术可获得较高成功率。与显微手术所涉及的学习曲线相比，该技术易于学习，是使输精管结扎男性“恢复”生育能力的有效方法。
