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• W2052120163 abstract "ObjectiveIn previously published series, the mean time for sperm to return to the ejaculate following vasovasostomy (VV) was 63 days. Long obstructive intervals between vasectomy and VV results in luminal discrepancies typically up to 5:1; leading to “dog ear” at the completion of the anastomosis. Evidently, sperm leak, granuloma, stricture, or obstruction. To address this problem, the microdot suture placement was introduced in 1995. The impact of this technique on patency rates and timing of return of sperm to the ejaculate has not been previously reported. The objective of this study is to evaluate the patency and the return of sperm to the ejaculate following microsurgical VV using the microdot.DesignRetrospectively review of medical records.Materials and MethodsWe evaluated the outcomes of men who underwent unilateral or bilateral VV between1983-1995 and between 1995-2012 by a single surgeon, the mean time since vasectomy is 11.7 years. All men had semen analyses (SA) at one month post-op, and every 3 months thereafter. Only men with at least one SA within the 6 month post-op were included. Vasoepididymostomy, or re-do VV were excluded. Chi-Square and unpaired t-test statistical analysis was performed.Results138 post 1995 men were identified, with a mean age of 43 (SD 6.8). Patency rates following microdot-VV were 99.98% compared to 89% (n=255) prior to the microdot technique (P= 0.0016). The mean time for return of sperm to the ejaculate was 35.5 (SD 11.8) days (d) significantly lower than previously reported (35.5 vs. 63 d, P=0.0001). 86% of men had sperm in their ejaculate within 44 d of the procedure, and 99.9% of men had sperm in the ejaculate within 56 d of the procedure.ConclusionMicrodot technique allows for accurate suture placement and eliminates the “dog ear” phenomenon. Patency rates following the introduction of the microdot technique at our institution were significantly higher than those previously published, with nearly all patients having sperm return to the ejaculate within 2 months. ObjectiveIn previously published series, the mean time for sperm to return to the ejaculate following vasovasostomy (VV) was 63 days. Long obstructive intervals between vasectomy and VV results in luminal discrepancies typically up to 5:1; leading to “dog ear” at the completion of the anastomosis. Evidently, sperm leak, granuloma, stricture, or obstruction. To address this problem, the microdot suture placement was introduced in 1995. The impact of this technique on patency rates and timing of return of sperm to the ejaculate has not been previously reported. The objective of this study is to evaluate the patency and the return of sperm to the ejaculate following microsurgical VV using the microdot. In previously published series, the mean time for sperm to return to the ejaculate following vasovasostomy (VV) was 63 days. Long obstructive intervals between vasectomy and VV results in luminal discrepancies typically up to 5:1; leading to “dog ear” at the completion of the anastomosis. Evidently, sperm leak, granuloma, stricture, or obstruction. To address this problem, the microdot suture placement was introduced in 1995. The impact of this technique on patency rates and timing of return of sperm to the ejaculate has not been previously reported. The objective of this study is to evaluate the patency and the return of sperm to the ejaculate following microsurgical VV using the microdot. DesignRetrospectively review of medical records. Retrospectively review of medical records. Materials and MethodsWe evaluated the outcomes of men who underwent unilateral or bilateral VV between1983-1995 and between 1995-2012 by a single surgeon, the mean time since vasectomy is 11.7 years. All men had semen analyses (SA) at one month post-op, and every 3 months thereafter. Only men with at least one SA within the 6 month post-op were included. Vasoepididymostomy, or re-do VV were excluded. Chi-Square and unpaired t-test statistical analysis was performed. We evaluated the outcomes of men who underwent unilateral or bilateral VV between1983-1995 and between 1995-2012 by a single surgeon, the mean time since vasectomy is 11.7 years. All men had semen analyses (SA) at one month post-op, and every 3 months thereafter. Only men with at least one SA within the 6 month post-op were included. Vasoepididymostomy, or re-do VV were excluded. Chi-Square and unpaired t-test statistical analysis was performed. Results138 post 1995 men were identified, with a mean age of 43 (SD 6.8). Patency rates following microdot-VV were 99.98% compared to 89% (n=255) prior to the microdot technique (P= 0.0016). The mean time for return of sperm to the ejaculate was 35.5 (SD 11.8) days (d) significantly lower than previously reported (35.5 vs. 63 d, P=0.0001). 86% of men had sperm in their ejaculate within 44 d of the procedure, and 99.9% of men had sperm in the ejaculate within 56 d of the procedure. 138 post 1995 men were identified, with a mean age of 43 (SD 6.8). Patency rates following microdot-VV were 99.98% compared to 89% (n=255) prior to the microdot technique (P= 0.0016). The mean time for return of sperm to the ejaculate was 35.5 (SD 11.8) days (d) significantly lower than previously reported (35.5 vs. 63 d, P=0.0001). 86% of men had sperm in their ejaculate within 44 d of the procedure, and 99.9% of men had sperm in the ejaculate within 56 d of the procedure. ConclusionMicrodot technique allows for accurate suture placement and eliminates the “dog ear” phenomenon. Patency rates following the introduction of the microdot technique at our institution were significantly higher than those previously published, with nearly all patients having sperm return to the ejaculate within 2 months. Microdot technique allows for accurate suture placement and eliminates the “dog ear” phenomenon. Patency rates following the introduction of the microdot technique at our institution were significantly higher than those previously published, with nearly all patients having sperm return to the ejaculate within 2 months." @default.
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• W2052120163 date "2013-09-01" @default.
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• W2052120163 title "Microdot vasovasostomy improves patency and reduces time for return of sperm to the ejaculate" @default.
• W2052120163 doi "https://doi.org/10.1016/j.fertnstert.2013.07.1314" @default.
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