(O-09) VARIATION IN MICROSURGICAL TECHNIQUE FOR VASECTOMY REVERSAL: EXPERIENCE FROM A UNIVERSITY HOSPITAL IN RIO DE JANEIRO

Abstract

Vasectomy is a widely performed male sterilization surgery with rapid recovery. In Brazil, it is carried out following legal criteria for family planning. Vasectomy reversal is a procedure with a high success rate and is considered a cost-effective option compared to other fertility techniques. The microsurgical technique, developed in 1975, is widely adopted for reconstructing the vas deferens. Vasovasostomy is the gold standard technique, using non-absorbable sutures (9-0 or 10-0). The aim of this study is to correlate the literature's results with those achieved through the microsurgical technique employed at the Pedro Ernesto University Hospital. This study was a retrospective and descriptive analysis of medical records and a review of the literature on a surgical technique. We analyzed 56 cases performed between January 2012 and December 2022 at the Pedro Ernesto University Hospital. Additionally, scientific articles published between 1999 and 2022 were collected. Surgeries were performed under general or spinal anesthesia, using a single-layer technique with Prolene 7-0 sutures. All patients underwent sperm analysis at 1, 3, and 6 months postoperatively. A total of 56 vasectomy reversals were performed in patients with an average age of 42.91 years and an average interval of 7.65 years between vasectomy and reversal. The patency rate was 82.14%, and the pregnancy rate among those who were successfully reversed was 15.22%. Reversal was more successful (87.18% patency and 25% pregnancy) in patients with an interval of less than 10 years between surgeries. The results of 56 vasectomy reversals by vasovasostomy using the modified microsurgical technique applied at the Pedro Ernesto University Hospital demonstrated satisfactory patency and pregnancy rates, closely matching those reported in the literature. The technique proved to be effective and safe, with no significant complications. No conflict.