[Experience with microsurgical two-layer vasovasostomy].

Excellent results of vasectomy reversal have been reported by Silber and Owen in 1977 using microsurgical technique without splints. Herein, we report two cases of male sterility due to previous voluntary vasectomy in which fertility was restored by microsurgical vasovasostomy. The reason for vasectomy reversal in these cases was a subsequent marriage. Case 1: A 36-year-old male who had had vasectomy 3 years earlier, underwent vasovasostomy on September 20th 1976. The sperm granuloma was not found, but sperm was observed in the fluid from the proximal cut-end of the vas deferens at the time of operation. He fathered a baby on October 2, 1977. Case 2: A 43-year-old male who had had vasectomy 10 years ago underwent vasovasostomy on February 5th 1980. Sperm granuloma was observed at the time of operation. He fathered a baby on February 25th 1981. The important factors that determine the success of vasectomy reversal are the method and time of reversal. 1) Microsurgical two-layer vasovasostomy is the most reliable method among the various operations for vasectomy reversal. 2) A shorter duration between vasectomy and it's reversal, and the existence of sperm granuloma after previous vasectomy increase the possibility to restore fertility.