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2016 ; 18
(3
): 365-71
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Vasectomy reversal: a clinical update
#MMPMID26975488
Patel AP
; Smith RP
Asian J Androl
2016[May]; 18
(3
): 365-71
PMID26975488
show ga
Vasectomy is a safe and effective method of contraception used by 42-60 million
men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the
death of a child or divorce and remarriage, change in financial situation, desire
for more children within the same marriage, or to alleviate the dreaded
postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more
technically challenging procedure that is performed only by a minority of
urologists and places a larger financial strain on the patient since it is
usually not covered by insurance. Interest in this procedure has increased since
the operating microscope became available in the 1970s, which consequently led to
improved patency and pregnancy rates following the procedure. In this clinical
update, we discuss patient evaluation, variables that may influence reversal
success rates, factors to consider in choosing to perform vasovasostomy versus
vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate
postvasectomy pain syndrome. We also review the use of robotics for vasectomy
reversal and other novel techniques and instrumentation that have emerged in
recent years to aid in the success of this surgery.
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