BOOK REVIEW: Vasectomy Reversal: Manual of Vasovasostomy and Vasoepididymostomy, by Sheldon Marks
Reviewed by: Mary K. Samplaski, M.D.
Institute of Urology, University of Southern California, Los Angeles, California
In Vasectomy Reversal: Manual of Vasovasostomy and Vasoepididymostomy (1), Sheldon Marks has written the most comprehensive book dedicated to vasectomy reversals to date. Given the high level of surgical skill and precision necessary for this operation, this book is a valuable resource. The first section is about patient selection and counseling, including optimizing testicular function, minimizing perioperative risks, and patient expectation setting. This is followed by a section on predicting vasectomy reversal success, with discussions on the impact of granulomas, antisperm antibodies, and female factors.
The second section of the book is dedicated to the vasectomy reversal procedure. The minutiae of this delicate operation are discussed, with advice on handling unexpected intraoperative findings based on Dr. Marks’s extensive experience. One- and two-layer vasovasostomies are described in detail, followed by vasoepididymostomy, arguably the most challenging anastomosis in male infertility microsurgery. The detailed descriptions of all operations include discussions about unplanned intraoperative situations, such as suture breaks and mucosal tears. Finally, there is an entire chapter dedicated to intraoperative dilemmas and challenges, including indeterminate vasal fluid findings, long vasal gaps, thickened epididymal tunics, and other unexpected findings.
The third section of the book focuses on postoperative care, managing complications, and sperm kinetics. There is a section about redo reversals: counseling patients, the unique challenges involved, and anticipated intraoperative findings. This is followed by an overview of future potential reversal technologies, including laser assistance, glue assistance, intraluminal stents, and robot assistance. Near the conclusion of the book, Dr. Marks details the exact instruments and sutures that he uses for his vasectomy reversals, including the individual product numbers for most of them. This information allows the reader to actually obtain the equipment described in the preceding sections.
Overall, this manual is the best “textbook” on vasectomy reversals available today. It is a useful resource for both those early in their careers as well as more seasoned microsurgeons wanting to optimize their vasectomy reversal success rates.
1. Marks SHF. Vasectomy Reversal: Manual of Vasovasostomy and Vasoepididymostomy: Springer International, 2018.