If an initial reversal fails, then for selected patients a redo or salvage reversal may be a reasonable option with high success in skilled, experienced hand. Of course, there are unique challenges and limitations when attempting to reverse a failed first attempt, both with intraoperative decision-making and the technical aspects of the anastomosis. Redo reversals are more likely to be successful if there was a return of sperm into the ejaculate before becoming azoospermic, which is consistent with development of a post-op anastomotic stricture rather than originally performing an incorrect procedure. Of course, anyone that has performed redo reversals will tell you that redo salvage reversals are inherently more challenging and time-consuming because of the extensive scarring and distortion of normal anatomy.
KeywordsRedo reversal success Prior operative note Redo reversal medical management Intraoperative findings and challenges Post-redo reversal compliance
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