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With strict adherence to the strategy, end\u2010to\u2010end VV was only performed if spermatozoa had been demonstrated at the epididymal stump of the vas. In all other cases, EV was carried out in a preocclusive region of the epididymal tubule. The outpatient procedure of refertilization was associated with a very low complication rate, which underlines its minimal\u2010invasive character. The follow\u2010up rate was 71%, the overall patency rate was 89% and the pregnancy rate was 59%. Secondary azoospermia was only observed in 1% of the patients. In relation to the intervals of obstruction, the patency and pregnancy rates were higher after short\u2010term obstruction than after long\u2010term obstruction. Correspondingly, higher success rates were found after VV than after EV. This is understandable because the probability for indication of EV increases with longer periods of obstruction. There is a significant discrepancy between patency and pregnancy rates that is likely to be caused by a relevant number of patients with post\u2010operative asthenozoospermia. The duration of obstruction is an important factor concerning epididymal damage, but it only disproportionately affects the results of refertilization if the technology of EV is implemented consistently in case of an epididymal granuloma. Good clinical results are achieved with this strategy, as evidenced by pregnancy rates and semen analyses.<\/jats:p>","DOI":"10.1111\/j.1365-2605.2012.01270.x","type":"journal-article","created":{"date-parts":[[2012,4,20]],"date-time":"2012-04-20T13:34:36Z","timestamp":1334928876000},"page":"706-713","source":"Crossref","is-referenced-by-count":21,"title":["Vasectomy reversal using a microsurgical three\u2010layer technique: one surgeon\u2019s experience over 18\u2003years with 1300 patients"],"prefix":"10.1111","volume":"35","author":[{"given":"J. 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