Comparison vasovasostomy outcomes by macroscopic one-layer anastomosis with vasovasostomy by microscopic two-layer anastomosis between men that had vasectomied

Abstract

Introduction:Vasovasostomy is the most common surgery to restore the fertility of vasectomized men. Purpose: This study was designed and performed to compare vasovasostomy by microscopic double layer anastomosis with macroscopic single layer anastomosis in vasectomy patients. Methods: This historical prospective study was performed on the medical records of 100 patients who underwent vaso vasostomy surgery in Imam Reza (AS) in Kermanshah (80 people) and Sina in Tabriz (20 people) during 2014-2017 . All information of each patient, including demographic information, sperm analysis, etc., was collected in an information form and entered into the software. To analyze the data, Chi-square test, independent t-test and survival analysis of these patients (fertility outcome) were performed by non-parametric methods (Kaplan Meyer) and Cox regression. All calculations were performed with SPSS software version 25 and the significance level was considered 0.05. Results: Fertility rate in patients with double-layer anastomosis by vasostasis was 15% (n = 3) and one-layer 80% (n = 12). This difference was not statistically significant (P <0.05). Based on the findings, there was a statistically significant difference between the mean percentage of sperm morphology according to the type of surgery (P <0.05). There was no statistically significant difference between the mean sperm count, sperm motility percentage, and mean hospital costs according to the type of surgical procedure (P <0.05). The incidence of spouse pregnancy in bilayer anastomosis after 15 and 24 months after follow-up was 87.5% and 58.3%, respectively. In patients with unilateral anastomosis, the incidence of pregnancy 13 and 15 months after surgery was 98.7% and 95.8%, respectively. The mean and median time of pregnancy in the spouses of patients with each surgical shower were 24 and 25 months. Other variables had no significant effect on spouse pregnancy (p <0.05).