Robo-Vasectomy Reversal

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There have been several recent developments in the world of vasectomy reversal. At the University of Florida urologists have used robot-assisted surgery to cut about 20 minutes off average surgery time for conventional vasectomy reversal which uses a microscope. “For a couple that’s trying to get pregnant, this is a big deal,” said Sijo Parekattil, MD, director of male infertility and microsurgery at UF, who led the study.

This might seem inconsequential, but a shorter procedure results in several positives. Less risk for the patient obviously, and less cost in that the surgical room and staff are being used less. Since the robotic approach is about $3000 more out of pocket than the traditional microscopic procedure, this is an important cost savings. Also a greater comfort level for the surgeon who bends or leans over the patient through the entire procedure.

The goal: to achieve a healthy and effective sperm count asap. Sperm count after either type of surgery - microscopic or robotic - is comparable at the end of a year. However, just two months after surgery, the robo-reversals had an average sperm count of 54 million compared to 11 million in the micro-reversals. That’s a big deal for couples eager, for whatever reason, to get pregnant. More sperm more quickly increases the number of chances for the desired result.

Robotic vasectomy reversal is not without controversy among specialists who say that using an expensive robot is just fancy for fancy’s sake and ultimately a waste of resources. “The big question is did it improve outcomes - either pregnancy rates or the time spent in surgery?” said professor Jay Sandlow MD, vice chair of the department of urology at Medical College of Wisconsin, who initially had reservations about the procedure but now sees the value. He acknowledges that the shorter procedure time has undeniable benefits.

Nevertheless, it is too soon to tell whether pregnancy rates have improved since the mid-2009 conclusion of the one-year study in which 20 men had the robotic procedure and seven had the microscopic one. If that should happen, then potential parents trying to beat the biological clock would be well-armed.

Source: Science Daily, University of Florida, Northwestern Memorial Hospital


 
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