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대한생식의학회지 제2권 제1호 2010년
정관(精管) 정관(精管) 문합술(吻合術)의 경험(經驗)
서울대학교 의과대학 필기과학교실;
이희영;,
CLINICAL EXPERIENCES OF VASOVASOSTOMIES
Lee, Hee-Yong;
Dept. of Urology, College of Medicine, Seoul National University, Korean Association for Voluntary Sterilization;
A total of 185 vasovasostomies were carried out for 11 years. Various factors which are of importance in fluencing the successful vasovasostomies are analysed and presented as follows: In recent years, demand of reanastomosis of the vas deferens increased considerably. An average age of the subjects is 39, and that of their wives, 33 in this series. An average interval between vasectomy and vasovasostomy is 4 years. An average number of living chidren is 2.6 at the time of vasectomy. and 2.1 at the time of time of vasovasostomy. Merchant and public official are the most commonly encounterd occupation in the present series. Coital frequencies are 2.2/week after vasovasostomy. The most common reasons for requesting the vasovasostomy are remarriage and deaths of children, especially son. Success rate is considerably higher among younger group than that of the older. Success rate is somewhat higher among groups of shorter interval between the operations (vasectomy and vasovasostomy) than that of longer interval group. Success rate is higher among bilateral vasovasostomy group than that of any others. Success rate is higher in solid splint group and no splint group than hollow splint group. The closed dressing technique of the end of splint on the scrotum is found to be reasonably effective in preventing infection. Ordinary end-to-end anastomosis and folded side-to-side anastomosis techniques are proved to be the most ideal form of modified operation for the successful vasovasostomies. The most common causes of failure are infection, injuries of blood supply, avascular necrosis due to extensive mobilization, inadequate approximation of both vasal end, hematoma, changes of epididymal environment, and early ambulation in this series. Overall success rate of the author's series is found the 81 per cent, and impregnation rate is 35 per cent. Overall results reported by other workers are that success rate regarding appearance of sperm in the semen after operation is 64 per cent, and that of impregnation after vasovasostomy is 33 per cent. The results of semen assessment performed on same cases prior to vasectomy and following vasovasostomy showed that post-vasovasostomy sperm count scarcely reached three-quaters of pre-vasectomy count.
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