Microsurgical vasectomy reversal: results and predictors of success

Dohle, Gert R.; Smit, Marij

doi:10.1007/bf03035149

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…Ultimately, 95 studies were included in this review. Eighty studies were included in the quantitative analyses, 25–104 whereas 15 studies were only included in the quantitative synthesis (Figure 1). 105–119 …”

Section: Resultsmentioning

confidence: 99%

Vasovasostomy: A systematic review and meta‐analysis comparing macroscopic, microsurgical, and robot‐assisted microsurgical techniques

Seth,

Gibson,

Bulloch

et al. 2023

Andrology

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Background and objectivesVasovasostomy is a cost‐effective procedure for the reversal of vasectomy. A water‐tight adequately blood‐supplied mucosal anastomosis is required for better outcomes. This review aimed to compare the outcome of vasovasostomy performed by three different techniques: macroscopic, pure microsurgical, and robot‐assisted microsurgical techniques.MethodsScopus, Web of Science, PubMed, Embase, and Cochrane library databases were searched for relevant studies from January 1901 to June 2023. We conducted our quantitative syntheses using the inverse variance method in OpenMeta software. The study's protocol was registered on PROSPERO.ResultsThis review involved 95 studies of different designs, with a total sample size of 48,132. The majority of operations were performed bilaterally, and participants were monitored for up to 10 years. The pooled patency rate was the highest following robot‐assisted vasovasostomy (94.4%), followed by pure microsurgical vasovasostomy (87.5%), and macroscopic vasovasostomy (83.7%). The pooled pregnancy rate following purely microsurgical vasovasostomy was higher than that of macroscopic vasovasostomy (47.4 vs. 43.7%). Definitive pregnancy rates in robotic vasovasostomy are yet to be determined.ConclusionPatency outcomes for vasovasostomy were best with robot‐assisted microsurgical technique, followed by pure microsurgical technique, and conventional macroscopic technique. Further investigations of robot‐assisted microsurgical vasovasostomy outcomes and randomized control trials are required to support this evidence.

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Section: Resultsmentioning

confidence: 99%

Vasovasostomy: A systematic review and meta‐analysis comparing macroscopic, microsurgical, and robot‐assisted microsurgical techniques

Seth,

Gibson,

Bulloch

et al. 2023

Andrology

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Outcomes of Macrosurgical Versus Microsurgical Vasovasostomy in Vasectomized Men: a Systematic Review and Meta-analysis

Duijn

Zee

Bachour

2021

SN Compr. Clin. Med.

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In order to restore fertility by vasectomy reversal, vasovasostomy (VV) is one of the most chosen options. During this procedure, the vas deferens is anastomosed either by a macro- or microscopical technique. Up to date, it is unknown which of these techniques shows best overall post-procedure patency and pregnancy rates. The purpose of this systematic review and meta-analysis is to reach a consensus on which technique is best for vasovasostomy and thereby better counsel patients and practitioners. A systematic review and meta-analysis on macroscopic and microscopic VV for vasectomy reversal was performed. PubMed, The Cochrane Library, Embase, and Web of Science were systematically searched from inception until 2019. Studies and associated data were evaluated by two reviewers. Primary, data on post-operative patency and pregnancy rates, interval to reversal, and post-operative complications were extracted. Proportions (95% CI) and heterogeneity scores (I2) were calculated, using a random effects model. A total of 8305 patients were included by 25 studies. Descriptive analysis showed higher post-operative patency (80.5% vs 91.4%) and pregnancy rates (47.7% vs 73.3%) after microscopic vasovasostomy. Meta-analysis produced post-operative patency proportions of 0.80 (95% CI, 0.76–0.84) and 0.88 (95% CI, 0.83–0.92) after macro- and microscopic VV respectively. Proportions of post-operative pregnancy were 0.43 (95% CI, 0.35–0.50) after macroscopic VV and 0.47 (95% CI, 0.31–0.62) after microsurgical VV. Microscopic VV is associated with higher post-operative patency and pregnancy rates compared to macroscopic vasovasostomy. However, further research is needed because of shortage in high methodological quality and variety.

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Outcomes of Three Vasovasostomy Surgical Techniques in Vasectomized Men: A Systematic Review of the Current Literature

Duijn

Zee

Bachour

2023

SN Compr. Clin. Med.

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To investigate which surgical technique, macroscopic, microscopic or robot-assisted microscopic, shows highest postoperative patency- and pregnancy rates for vasectomy reversal (VR) by vasovasostomy (VV). This study is an updated version of the systematic review and meta-analysis entitled: “Outcomes of Macrosurgical Versus Microsurgical Vasovasostomy in Vasectomized Men: a Systematic Review and Meta-analysis” published in 2021. We performed a systematic review of the English-, Dutch-, and German-language literature that described postoperative outcomes of macroscopic, microscopic, or robot-assisted microscopic VV for VR. PubMed National Library of Medicine/MEDLINE, Embase, CENTRAL, The Cochrane Library, Web of Science and Scopus were searched from inception to June 2021. Two reviewers independently examined the studies and associated data for eligibility. Primary outcomes were postoperative patency and pregnancy rates. Data on interval to reversal (≤ 7 years and > 7 years) and postoperative complications were also extracted. Forty-nine studies met the inclusion criteria. We identified 46 retrospective studies and three randomized controlled trials (RCT). A total of 10,088 procedures were included. 6822 patients remained after loss to follow-up. The mean age at reversal of vasectomy was 38.0 years, and the mean interval to reversal was 6.5 years. The pooled mean postoperative patency rate was slightly higher after robot-assisted microsurgical VV (92.7%), compared to macrosurgical (81.9%) and pure microsurgical (90.1%) VV. Postoperative pregnancy rates were 42.7%, 69.7%, and 33.3% after macroscopic, pure microscopic and robot-assisted microscopic VV, respectively. Our results showed that microsurgical and robot-assisted microsurgical VV are associated with higher postoperative patency rates compared to the macrosurgical technique. VV with microsurgical assistance showed the highest post-operative pregnancy rates. However, more research is needed due to lack of RCTs and data on robot-assisted microsurgical VV.

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Microsurgical vasectomy reversal: results and predictors of success

Cited by 3 publications

References 30 publications

Vasovasostomy: A systematic review and meta‐analysis comparing macroscopic, microsurgical, and robot‐assisted microsurgical techniques

Vasovasostomy: A systematic review and meta‐analysis comparing macroscopic, microsurgical, and robot‐assisted microsurgical techniques

Outcomes of Macrosurgical Versus Microsurgical Vasovasostomy in Vasectomized Men: a Systematic Review and Meta-analysis

Outcomes of Three Vasovasostomy Surgical Techniques in Vasectomized Men: A Systematic Review of the Current Literature

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