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대한생식의학회지 제23권 제1호 2010년
정관내 부목을 이용한 정관복원술 : Permanent Silicone Stent의 효용가치
중앙대학교 의과대학 비뇨기과학교실;중앙대학교 의과대학 비뇨기과학교실;
김태형;김세철;,
Effectiveness of Permanent Silicone Stent-Assisted Vasovasostomy
Kim, Tae-Hyoung;Kim, Sae-Chul;
Department of Urology, College of Medicine, Chung Ang University;Department of Urology, College of Medicine, Chung Ang University;
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 22 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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