Vasectomy in Male Contraception and its Reversal

Vasectomy is an important option for male contraception. It is highly effective, but many questions about patient selection and information, surgical technique, postoperative follow-up, and complications have to be defined. The use of the no-scalpel technique to access the vasa is associated with the fewest complications. The technique with the lowest failure rate is catheterization of the vasa with fascial interposition. A single postvasectomy semen sample at 3 mo showing rare, azoospermia or nonmotile sperm is acceptable to confirm sterility. No data show that vasectomy is associated with the risk of prostate or testicular cancer.Up to 6% of men who have undergone vasectomy will demand reversal in the form of vasovasostomy or vasoepididymostomy for various reasons. In the age of in vitro fertilization, it becomes even more important to report outcomes after vasectomy reversals.The operative microscope for andrologic procedures has provided enhanced magnification and accuracy for vasectomy reversal. Now robot-assisted microsurgery is used more and more in andrology, but what is its interest in this particular indication?