A comparison of Modified One Layer Vasovasostomy with Optical Loupe and Microscope

Optical Loupe와 현미경을 이용한 단층정관정관문합술의 비교

Objective: The objective of this study was to compare results of the macroscopic one-layer vasovasostomy with those of microscopic one-layer vasovasostomy and to analyze the change of semen parameters according to the interval of vasal obstruction. Method and Materials: Between March 1987 and December 1997, we performed 121 vasovasostomies using modified one-layer technique with loupe magnification (macroscopic vasovasostomy) or microscope. Among the 68 could be followed post-operatively, 37 patients were treated by macroscopic technique with loupe, and 31 patients by microscopic technique. We compared rates of anatomical patency (sperm count above than $10{\times}10^{6}$/ml) and pregnancy of macroscopic vasovasotomy with those of microscopic vasovasostomy. Patency and pregnancy rates according to vasal obstructive interval were also examined. Results: The patency rates of macroscopic and microscopic technique were 86.5% and 87.1%, and pregnancy rates of macroscopic and microscopic technique were 64.9% and 67.7%. There was no statistical significance between these two methods (p>0.05). The pregnancy rates and sperm motility were decreased if more than 10 years had elapsed following vasectomy (p<0.05). Conclusion: We found little difference in success rates resulting from macroscopic and microscopic vasovasostomy and the former had the advantage of reduced cost and a lower operator skill level. In post-operative semen analysis, the sperm motility was the most probable factor associated with vasal obstructive interval.