Modified Double-Layer Microsurgical Technique: Effective and Desirable Method for Vasectomy Reversal

Background: Family planning is one of the important needs of reproductive health care. For years, stable, reliable, reversible, accessible, and cost-effective methods have been desirable for this purpose. Vasectomy is often considered as the most common contraceptive method, due to the highly effective reversal success rate. Objectives: With the excellent patency and pregnancy rates, the microsurgical end-to-end vasovasostomy procedure has been recognized as a more common method for vasectomy reversal. Methods: Here we reviewed and analyzed the records of our experience of Modified Double-Layer microsurgical technique (MDLT) for the vasovasostomy procedure (n = 30) compared with the Three-Layer technique (TLT) (n = 24) during 3 years. The statistical analyses were carried out using SPSS (V. 15.0), and a value of P < 0.05 was considered significant. Results: In this report, 54 participants underwent TLT-VV (group 1) and MDLT-VV (group 2). There was no significant difference in the causes of vasectomy reversal between the two groups (P value = 0.392). There was no significant difference between study groups in the fertility history (P value = 0.561), the presence of a sperm granuloma (P value = 0.21), underlying diseases (P value = 0.345) and demographic characteristics. We observed a 94% (51/54) patency rate and a 40.7% (22/54) pregnancy rate without any need for Assisted Reproductive technique (ART). Conclusions: The microscopic vasectomy reversal operation brings advantages to family planning and sexual health. High throughput return fertility, without any need for ART, places this technique in the first step of family planning. It seems Modified Double-Layer technique may be considered as the first step of microscopic vasovasostomy. Keywords: