Summary: Surgical anastomosis or fistulization of the spermatic ducts to restore fertility in a previously vasectomized male.

Top Publications

  1. Gerrard E, Sandlow J, Oster R, Burns J, Box L, Kolettis P. Effect of female partner age on pregnancy rates after vasectomy reversal. Fertil Steril. 2007;87:1340-4 pubmed
    ..Groups were similar with regard to types of procedure performed (vasovasostomy or vasoepididymostomy), obstructive interval, female factors, number of repeat procedures, and quality of ..
  2. Kolettis P, D Amico A, Box L, Burns J. Outcomes for vasovasostomy with bilateral intravasal azoospermia. J Androl. 2003;24:22-4 pubmed
    ..Vasectomy reversal was performed for 32 patients with intravasal azoospermia: 25 received bilateral vasovasostomy (VV), 1 had a bilateral VV, 5 underwent VV/VE, and 1 had bilateral VE...
  3. Jee S, Hong Y. One-layer vasovasostomy: microsurgical versus loupe-assisted. Fertil Steril. 2010;94:2308-11 pubmed publisher
    ..Fifty men with obstructive azoospermia after vasectomy. One-layer vasovasostomy with microscope (group I) or optical loupe (group II)...
  4. Parekattil S, Kuang W, Agarwal A, Thomas A. Model to predict if a vasoepididymostomy will be required for vasectomy reversal. J Urol. 2005;173:1681-4 pubmed The model is 100% sensitivity in detecting those patients who may require a VE during vasectomy reversal (specificity of 58.8%). It may allow urologists to preoperatively identify these patients. ..
  5. Sandlow J, Kolettis P. Vasovasostomy in the convoluted vas deferens: indications and outcomes. J Urol. 2005;173:540-2 pubmed
    We examined the indications for vasovasostomy (VV) in the convoluted vas deferens as well as the outcome of this procedure...
  6. Jokelainen O, Rintala E, Koskimies A, Rannikko S. Vasovasostomy--a 15-year experience. Scand J Urol Nephrol. 2001;35:132-5 pubmed
    ..The serum follicle-stimulating hormone concentrations were normal, with no association with the pregnancy rate. Macroscopic vasovasostomy is an effective means of re-establishing fertility in vasectomized men.
  7. Patel S, Sigman M. Comparison of outcomes of vasovasostomy performed in the convoluted and straight vas deferens. J Urol. 2008;179:256-9 pubmed
    We compared postoperative semen analysis parameters and patency rates of vasovasostomy performed in the convoluted vs straight portion of the vas deferens.
  8. Nagler H, Belletete B, Gerber E, Dinlenc C. Laparoscopic retrieval of retroperitoneal vas deferens in vasovasostomy for postinguinal herniorrhaphy obstructive azoospermia. Fertil Steril. 2005;83:1842 pubmed
    ..A tension-free, patent anastomosis was performed. Polypropylene mesh-induced fibrosis of the vas deferens can result in obstructive azospermia. Laparoscopy can be used to permit a microsurgical bypass of the obstructed segment. ..
  9. Chan P, Goldstein M. Superior outcomes of microsurgical vasectomy reversal in men with the same female partners. Fertil Steril. 2004;81:1371-4 pubmed
    ..6%) were identified who had the same partners as before their vasectomy. Microsurgical vasovasostomy or vasoepididymostomy. Semen parameters, clinical pregnancy, and live birth rates...

More Information


  1. Hinz S, Rais Bahrami S, Kempkensteffen C, Weiske W, Schrader M, Magheli A. Fertility rates following vasectomy reversal: importance of age of the female partner. Urol Int. 2008;81:416-20 pubmed publisher
    ..Therefore, vasectomy reversal should be the treatment of choice for patients with advanced maternal age desiring reinstated fertility following vasectomy. ..
  2. Kolettis P, Sabanegh E, Nalesnik J, D Amico A, Box L, Burns J. Pregnancy outcomes after vasectomy reversal for female partners 35 years old or older. J Urol. 2003;169:2250-2 pubmed
    ..Mean partner age was 37 +/- 2 years, and median obstructive interval was 10 years. Bilateral vasovasostomy was performed in 43 men, unilateral vasovasostomy in 2 and vasovasostomy/vasoepididymostomy in 1...
  3. Hinz S, Rais Bahrami S, Weiske W, Kempkensteffen C, Schrader M, Miller K, et al. Prognostic value of intraoperative parameters observed during vasectomy reversal for predicting postoperative vas patency and fertility. World J Urol. 2009;27:781-85 pubmed publisher
    ..Our aim is to determine the value of intraoperative semen consistency and quality as well as the presence of a sperm granuloma on predicting vas patency and fertility following vasectomy reversal...
  4. Kolettis P, Sabanegh E, D Amico A, Box L, Sebesta M, Burns J. Outcomes for vasectomy reversal performed after obstructive intervals of at least 10 years. Urology. 2002;60:885-8 pubmed
    ..As with all infertile couples, close collaboration between the urologists and gynecologists is essential to provide the most appropriate care. ..
  5. Fleming C. Robot-assisted vasovasostomy. Urol Clin North Am. 2004;31:769-72 pubmed
    Robot-assisted vasovasostomy is an attractive alternative to traditional microscopic techniques for several reasons. The normal physiologic tremor is removed and greater ease and precision of suture placement is possible...
  6. Anger J, Goldstein M. Intravasal "toothpaste" in men with obstructive azoospermia is derived from vasal epithelium, not sperm. J Urol. 2004;172:634-6 pubmed
    ..Our findings in men with segmental dysplasia of the vas deferens indicate that vasal "toothpaste" must be derived from vasal epithelium, not sperm. ..
  7. Hsieh M, Meng M, Turek P. Markov modeling of vasectomy reversal and ART for infertility: how do obstructive interval and female partner age influence cost effectiveness?. Fertil Steril. 2007;88:840-6 pubmed
    ..With increasing WTP, ART is more cost effective over wider windows of female age. Markov modeling of fertility after vasectomy suggests female age has more impact than vasectomy obstructive interval on cost effectiveness. ..
  8. Kuang W, Shin P, Matin S, Thomas A. Initial evaluation of robotic technology for microsurgical vasovasostomy. J Urol. 2004;171:300-3 pubmed
    Conventional microscope assisted vasovasostomy (MAVV) is a technically difficult procedure that is most successful in the hands of well-trained microsurgeons...
  9. Parekattil S, Atalah H, Cohen M. Video technique for human robot-assisted microsurgical vasovasostomy. J Endourol. 2010;24:511-4 pubmed publisher
    Previous studies have shown that robot-assisted microsurgical vasovasostomy (RAVV) has technical advantages over pure microscopic vasovasostomy (MVV) in animal and human models...
  10. Ho K, Witte M, Bird E, Hakim S. Fibrin glue assisted 3-suture vasovasostomy. J Urol. 2005;174:1360-3; discussion 1363 pubmed
    We report on the early results of fibrin glue assisted, 3-suture microsurgical vasovasostomy (FGV) technique in humans. After Institutional Review Board approval, 42 patients were enrolled prospectively from October 2002 to March 2004...
  11. Magheli A, Rais Bahrami S, Kempkensteffen C, Weiske W, Miller K, Hinz S. Impact of obstructive interval and sperm granuloma on patency and pregnancy after vasectomy reversal. Int J Androl. 2010;33:730-5 pubmed publisher
    ..However, when counselling patients and their female partners, it is of utmost importance to stress that the age of the female partner is an independent predictor of successful vasectomy reversal...
  12. Hollingsworth M, Sandlow J, Schrepferman C, Brannigan R, Kolettis P. Repeat vasectomy reversal yields high success rates. Fertil Steril. 2007;88:217-9 pubmed
  13. Boyle K, Thomas A, Marmar J, Hirshberg S, Belker A, Jarow J. Sperm harvesting and cryopreservation during vasectomy reversal is not cost effective. Fertil Steril. 2006;85:961-4 pubmed
    ..Vasectomy reversal procedures modeled included bilateral vasovasostomy and bilateral epididymovasostomy...
  14. Schiff J, Li P, Goldstein M. Robotic microsurgical vasovasostomy and vasoepididymostomy: a prospective randomized study in a rat model. J Urol. 2004;171:1720-5 pubmed
    Microsurgical vasovasostomy and vasoepididymostomy remain technically challenging procedures. Refinements in technique have continually improved patency and pregnancy rates for the 2 procedures in experienced hands...
  15. Boorjian S, Lipkin M, Goldstein M. The impact of obstructive interval and sperm granuloma on outcome of vasectomy reversal. J Urol. 2004;171:304-6 pubmed
  16. Paick J, Park J, Park D, Park K, Son H, Kim S. Microsurgical vasovasostomy after failed vasovasostomy. J Urol. 2003;169:1052-5 pubmed
    We analyzed our experience with repeat microsurgical vasovasostomy after failed vasovasostomy and elucidate the possible predictors of surgical outcome. We evaluated 62 repeat vasectomy reversal cases with followup data available...
  17. Chawla A, O Brien J, Lisi M, Zini A, Jarvi K. Should all urologists performing vasectomy reversals be able to perform vasoepididymostomies if required?. J Urol. 2004;172:1048-50 pubmed
    ..may occur following a vasectomy and that some men should undergo vasoepididymostomy (VE) rather than vasovasostomy (VV), the practice of many urologists in our region has been to offer only VV for vasectomy reversal...
  18. Kim A, Shin D, Martin T, Honig S. Laparoscopic mobilization of the retroperitoneal vas deferens for microscopic inguinal vasovasostomy. J Urol. 2004;172:1948-9 pubmed
  19. Schiff J, Chan P, Li P, Finkelberg S, Goldstein M. Outcome and late failures compared in 4 techniques of microsurgical vasoepididymostomy in 153 consecutive men. J Urol. 2005;174:651-5; quiz 801 pubmed
    ..006). ..
  20. Lee R, Li P, Goldstein M, Tanrikut C, Schattman G, Schlegel P. A decision analysis of treatments for obstructive azoospermia. Hum Reprod. 2008;23:2043-9 pubmed publisher
    ..The absolute cost-effectiveness of all therapies improved over time. These results may be tailored with institution-specific data to allow more individualized results. ..
  21. Vrijhof E, De Bruine A, Zwinderman A, Lycklama A Nijeholt A, Koole L. The use of a newly designed nonabsorbable polymeric stent in reconstructing the vas deferens: a feasibility study in New Zealand white rabbits. BJU Int. 2005;95:1081-5 pubmed
    ..001). The total sperm counts, motility and PMSD showed no or little difference after surgery between the conventional and stented rabbits. The stented reconstruction was easy, had no secondary stricturing and reduced the operating time. ..
  22. Hsieh M, Huang H, Chen Y, Huang S, Chang P. Loupe-assisted vs microsurgical technique for modified one-layer vasovasostomy: is the microsurgery really better?. BJU Int. 2005;96:864-6 pubmed
    To compare the outcome of loupe-assisted, modified one-layer vasovasostomy (MOLV) and conventional microsurgical MOLV for vasectomy reversal...
  23. Kim S, Ku J, Park K, Son H, Paick J. A different female partner does not affect the success of second vasectomy reversal. J Androl. 2005;26:48-52 pubmed
    ..However, it should be considered that the likelihood of achieving pregnancy after repeat vasectomy reversal may decrease with advancing age of the female partner. ..
  24. Schiff J, Li P, Goldstein M. Robotic microsurgical vasovasostomy and vasoepididymostomy in rats. Int J Med Robot. 2005;1:122-6 pubmed
    ..the da Vinci surgical robot in order to determine the feasibility of adapting the robot to microsurgical vasovasostomy and vasoepididymostomy...
  25. Shaeer O, Shaeer K. Pelviscrotal vasovasostomy: refining and troubleshooting. J Urol. 2005;174:1935-7 pubmed
    ..This technique, termed Shaeer pelviscrotal vasovasostomy, is easier to perform with much less morbidity...
  26. Busato W, Marquetti A, Rocha L. Comparison of vasovasostomy with conventional microsurgical suture and fibrin adhesive in rats. Int Braz J Urol. 2007;33:829-36 pubmed
    Microsurgical procedures are currently the gold standard for vasovasostomy with excellent results, but it takes an increased operative time demanding special training and experience in microsurgery...
  27. Kolettis P, Burns J, Nangia A, Sandlow J. Outcomes for vasovasostomy performed when only sperm parts are present in the vasal fluid. J Androl. 2006;27:565-7 pubmed
    This article reviews the outcomes for vasovasostomy (VV) when only sperm parts were present in the vasal fluid...
  28. Sigman M. The relationship between intravasal sperm quality and patency rates after vasovasostomy. J Urol. 2004;171:307-9 pubmed
    Most surgeons examine the intravasal fluid at vasectomy reversal. Vasovasostomy is performed when sperm are identified in the intravasal fluid or when sperm are absent but the fluid is copious and clear...
  29. Shiraishi K, Takihara H, Naito K. Influence of interstitial fibrosis on spermatogenesis after vasectomy and vasovasostomy. Contraception. 2002;65:245-9 pubmed
    ..Testicular biopsy specimens from 21 consecutive men were obtained at vasovasostomy. Percent of interstitial fibrosis was determined quantitatively by NIH-image after Masson Trichrome staining...
  30. Shaeer O, Shaeer K. Laparoscopy-assisted pelvi-scrotal vasovasostomy. Andrologia. 2004;36:311-4 pubmed
    Iatrogenic obstruction of the vas deferens within the inguinal canal can be managed by direct on-site vasovasostomy. However, in cases with large defect of the vas, the anastomosis may be under tension...
  31. Niederberger C, Makhlouf A. Vasectomy reversal in the presence of diminished ovarian reserve: a complex clinical conundrum. J Androl. 2006;27:3-5 pubmed
  32. Stauffer C, Parsons C. Fibronectin levels in male ejaculate and evidence for its role in unexplained infertility. Urology. 1989;34:80-5 pubmed
    b>Vasovasostomy has become a popular and highly successful method of restoring fertility to those who have undergone a vasectomy...
  33. Patel A, Smith R. Vasectomy reversal: a clinical update. Asian J Androl. 2016;18:365-71 pubmed publisher
    ..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...
  34. Olive D, Pritts E. Markov modeling: questionable data in, questionable data out. Fertil Steril. 2008;89:746-7 pubmed publisher
  35. Fenig D, Kattan M, Mills J, Gisbert M, Yu C, Lipshultz L. Nomogram to preoperatively predict the probability of requiring epididymovasostomy during vasectomy reversal. J Urol. 2012;187:215-8 pubmed publisher
    Up to 6% of men who undergo vasectomy may later undergo vasectomy reversal. Most men require vasovasostomy but a smaller subset requires epididymovasostomy...
  36. Hsiao W, Goldstein M, Rosoff J, Piccorelli A, Kattan M, Greenwood E, et al. Nomograms to predict patency after microsurgical vasectomy reversal. J Urol. 2012;187:607-12 pubmed publisher
    ..64 and 0.66, respectively. To our knowledge this represents the first use of nomograms to predict the likelihood of patency after microsurgical vasectomy reversal. These nomograms may prove useful to guide further treatment decisions. ..
  37. Yang G, Walsh T, Shefi S, Turek P. The kinetics of the return of motile sperm to the ejaculate after vasectomy reversal. J Urol. 2007;177:2272-6 pubmed
    ..04). An obstructive interval of 8 years or less and undergoing vasovasostomy instead of epididymovasostomy predicted faster time to patency within the first 3 months after reversal...
  38. Inaba Y, Fujisawa M, Okada H, Arakawa S, Kamidono S. Clinical outcome of microsurgery for obstructive azoospermia. Int J Urol. 1999;6:139-44 pubmed
    ..e. vasovasostomy or unilateral epididymovasostomy)...
  39. Breeuwsma A, van Driel M, Mensink H. [Surprises during urological interventions due to incomplete medical histories]. Ned Tijdschr Geneeskd. 2003;147:1993-4 pubmed
    ..These underwent an examination whilst under general anaesthesia; the examination was converted to a vasovasostomy, as in both cases it was found that a vasectomy had previously been performed...
  40. Nagler H, Rotman M. Predictive parameters for microsurgical reconstruction. Urol Clin North Am. 2002;29:913-9, ix pubmed
    ..Factors that can affect the success of these procedures may become known preoperatively and intraoperatively; this article reviews each of those factors. ..
  41. Birch J, Mandley D, Williams S, Worrall D, Trotter P, Wilkinson F, et al. Methylene blue based protein solder for vascular anastomoses: an in vitro burst pressure study. Lasers Surg Med. 2000;26:323-9 pubmed
    ..Microsurgery 1985;6:229], and soldered anastomoses [Small et al., J Clin Laser Med Surg 1997;15:205]. The relationship between burst pressure strength and chromophore absorption is discussed. ..
  42. Vrijhof E, De Bruine A, Zwinderman A, Lycklama A Nijeholt A, Koole L. New nonabsorbable stent versus a microsurgical procedure for vasectomy reversal: evaluating tissue reactions at the anastomosis in rabbits. Fertil Steril. 2005;84:743-8 pubmed
    ..057) or PMSD (P=.13). The newly developed stent provided patency rates comparable with the conventional one-layer microscopic procedure but showed significantly less stricturing of the anastomoses. ..
  43. Gilbert B, Goldstein M. New directions in male reproductive microsurgery. Microsurgery. 1988;9:281-5 pubmed
    ..In this paper, we discuss some of the new directions in male reproductive microsurgery. ..
  44. Blach O, Shridharani A, Sandlow J. Analysis of international practice patterns regarding postvasectomy fertility options. Urology. 2014;83:1065-70 pubmed publisher
    ..Concordance with the indices of "best practice" improves with andrology training and increasing number of procedures performed. ..
  45. Herrel L, Hsiao W. Microsurgical vasovasostomy. Asian J Androl. 2013;15:44-8 pubmed publisher
    Up to 6% of men who have undergone vasectomy will ultimately elect for reversal in the form of vasovasostomy or vasoepididymostomy for various reasons...
  46. Eguchi J, Nomata K, Hirose T, Nishimura N, Igawa T, Kanetake H, et al. Clinical experiences of microsurgical side-to-end epididymovasostomy for epididymal obstruction. Int J Urol. 1999;6:271-4 pubmed
    ..3% (three of nine). These results suggest that reconstruction of the seminal tract should be considered first for obstructive azoospermia. ..
  47. Flickinger C, Vagnetti M, Howards S, Herr J. Antisperm autoantibody response is reduced by early repair of a severed vas deferens in the juvenile rat. Fertil Steril. 2000;73:229-37 pubmed a late repair group had vasa obstructed by ligation until after puberty, when they underwent microsurgical vasovasostomy (age 60 days). Antisperm antibodies were assayed by ELISA...
  48. Wood S, Thomas K, Sephton V, Troup S, Kingsland C, Lewis Jones I. Postoperative pain, complications, and satisfaction rates in patients who undergo surgical sperm retrieval. Fertil Steril. 2003;79:56-62 pubmed
    ..42% vs. 57%, respectively) and was associated with significantly fewer days absent from work (3.0 vs. 8.5). Surgical sperm retrieval by PESA or TESE is a safe procedure with only minor complications that is tolerated well by patients. ..
  49. Rollet J. There must be a better way. Contraceptive options for men. Adv Nurse Pract. 2004;12:66-8 pubmed
  50. Shin D, Chuang W, Lipshultz L. Vasovasostomy. BJU Int. 2004;93:1363-78 pubmed
  51. Sperling H, Eisenhardt A, Becker M, Rubben H. [Therapy for infertile couples]. Urologe A. 2005;44:1147-53 pubmed
    ..Using an interdisciplinary approach including urology, gynecology, reproductive medicine and human genetics, the treating physicians are able to fulfil the desire of infertile couples for a healthy child in many cases. ..
  52. Busato W. Vasectomy reversal: a seven-year experience. Urol Int. 2009;82:170-4 pubmed publisher
    ..There was no significant difference in the anastomosis time between the first 12 procedures and the next 12 procedures. ..
  53. Nalesnik J, Sabanegh E. Vasovasostomy: multiple children and long-term pregnancy rates. Curr Surg. 2003;60:348-50 pubmed
    To determine the long-term patency and pregnancy rates after vasovasostomy and to determine the likelihood of having more than 1 child after this procedure...