Vasovasostomie robot assistée : résultats sur le spermogramme post-opératoire à 3 mois & la fécondité secondaire à propos de 4 cas
Objective: Evaluation of the efficacy of robotic vasovasostomy post-vasectomy.
Patients and methods: We present a retrospective study of four patients aged from 36 to 51 years, who were operated of a vasovasostomy between September 2007 to July 2009. The same surgeon performed a robotic-assisted vasovasostomy, bilateral for three of them and only left unilateral for the last patient who underwent orchidectomy for right testicular seminoma. These patients had a preoperative semen analysis confirmed the absence of sperm after vasectomy. All patients had an outcome of spermatozoa on testicular deferens side in per-operative. The permeability of the distal vas deferens was systematically checked. The success criterion was the presence of spermatozoa in semen control three months. The paternity post vasovasostomy without medically assisted procreation due to father sterility was a secondary endpoint.
Results: Four patients had between 0.6 and 27 million sperm per mL in postoperative semen analysis. Three to seventeenth months after the vasovasostomy, the wives of four patients have started a pregnancy between.
Conclusion: The robotic vasovasostomy surgery is a technique that enabled this small group of patients having good results in regard to deferential recanalization and to recovery of secondary spontaneous fertility. A larger cohort needs to be evaluated. The medical and economical aspects of this method should be compared to those of usual technics, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).