Perfect anatomical reconstruction of vas deferens with a new microscopic surgical technique.

Early results with a new, two-layer microscopic technique for anastomosis of the vas deferens, using an operating microscope and ultrafine suture, reveal that patency of the vas deferens can be achieved in virtually every case. Normal sperm counts can be achieved in up to 95% of patients. Failure with conventional techniques is usually due to continuing partial obstruction. A poor sperm count after this technique is most likely due to an inherent inability of the patient to produce normal sperm, a likely sequela of chronic obstruction. Thus, while success is also good 10 years after vasectomy, it is not as predictable. Previous failure with a conventional operation does not limit success with a reoperation using the microscopic two-layer tehcnique. Operations on 200 patients since this original study are confirming these early results.