A 20-year experience with vasovasostomy.

A total of 624 of 699 vasovasostomy patients was followed during the last 20 years. Better results were obtained when there was shorter duration of obstruction, bilateral straight vas-to-straight was anastomosis and bilateral presence of sperm in the vas fluid during vasovasostomy. Results of end-to-end and side-to-side macrosurgical anastomosis, as well as of 1-layer and 2-layer microsurgical anastomosis were similar. Macrosurgical success rates were 84 per cent for patency and 35 per cent for pregnancy in the 300 cases. Microsurgical success rates were 90 per cent for patency and 51 per cent for pregnancy in 324 cases. Failure of patency was caused mainly by anastomotic scar formation with sperm and suture granulomas. Failure of pregnancy was owing mainly to inadequate postoperative semen quality.