Microsurgical vasovasostomy: an outpatient procedure under local anesthesia.

We performed microsurgical vasovasostomy on 25 outpatients using spermatic cord block anesthesia, an infrapubic incision and the 1 1/2-layer anastomosis technique. The average operating time was 2 hours 18 minutes and patients usually were discharged home after approximately 1 hour in the recovery room. Of the 21 patients who have had sperm counts performed 3 or more months postoperatively 19 have counts equal to or more than 20 million per ml., with an average motility of 43 per cent. Exclusive of the surgeon's fee, which is the same for inpatient and outpatient vasovasostomies, the average cost of the operation was +650, a savings of 41 per cent over the cost of an outpatient microsurgical vasovasostomy under general anesthesia and of 61 per cent over the cost of the procedure done on an inpatient basis under general anesthesia. The operation as described is safe and economical with minimal morbidity and has results comparable to those obtained with more complex and extensive vasovasostomy techniques.