Comparison of outcomes of vasovasostomy performed in the convoluted and straight vas deferens.

ABSTRACT

PURPOSE: We compared postoperative semen analysis parameters and patency rates of vasovasostomy performed in the convoluted vs straight portion of the vas deferens. MATERIALS AND METHODS: Records of patients that underwent bilateral vasovasostomy in the straight and convoluted vas deferens by a single surgeon were retrospectively analyzed. Patient age, partner age, obstructive interval, gross and microscopic appearance of the intraoperative fluid aspirated from the testicular portion of the vas deferens, and postoperative semen analysis results were examined. Patency was defined as any sperm in the postoperative ejaculate and was compared for the 2 groups. RESULTS: A total of 42 and 64 patients underwent bilateral straight vasovasostomy and convoluted vasovasostomy, respectively. Mean patient age for straight and convoluted vasovasostomy was 38.5 and 40.3 years, respectively. Mean obstructive interval for straight vasovasostomy and convoluted vasovasostomy was 7.7 and 8.6 years, respectively. No significant differences in the postoperative semen analysis parameters of volume, total count, sperm density, motility or total motile count were found between the 2 groups. The patency rate was 98.1% and 97.3% for convoluted vasovasostomy and straight vasovasostomy, respectively, and was not statistically different. CONCLUSIONS: Although vasovasostomy in the convoluted vas deferens is considered technically more challenging than in the straight vas deferens, patency rates and postoperative semen analysis parameters for convoluted vasovasostomy and straight vasovasostomy are comparable.