During a 2-year period microsurgical vasovasostomies using permanent silicone stent (c-shaped stent with 0.6mm slit, 5mm in length, 0.8mm in outer diameter, 0.5mm in inner diameter) were performed in 30 patients for vasectomy revesal. The
stent-assisted vasovasostomy (SVV) was intended to decrease the technical demand, the time requirement and the occurrence of reobstruction due to postoperative stricture. The effectiveness of the permanent silicone stent for vasovasostomy was
compared
with that of microsurgical two-layered vasovasostomy (VV). Sperms were present in all the ejaculates of the 25 men on semen analysis 1-2 months after SVV. Pregnancy occurred in 10 of 20 couples (45.5%) during 2-24 months of follow-up and it took
4-10
months (average 7.2 months) to get pregnant. Average operation time for the VV was 150 minutes and that for the SVV 125 minutes. Among 12 men who had sperms in the ejaculates 1-2 months after SVV, 4 revealed azoospermia 3-17 months
postoperatively.
Among the 4 patients with postoperative azoospermia, 2 underwent reoperation. On histopathologic examination, previously anastomsed sites showed obliterated lumen of the stent and strictures of vas proximal and/or distal to the stents due to
granulation
tissues. In conclusion, the SVV was not more efficacious in terms of patency and pregnancy rate than the VV.
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