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    In-office andrology: Videos show office-based hydrocelectomy, vasectomy reversal


    Office-based vasectomy reversal using local anesthesia - Landon W. Trost, MD




    The current video demonstrates an office-based approach for vasectomy reversal using only local anesthesia. Although office-based vasovasostomies have been previously performed in the office, the current video represents the first known description of an office-based epididymovasostomy under local anesthesia. Descriptions are provided on methods to optimize local pain control, and published outcomes of an initial series are presented. 

    Dr. Hotaling: Dr. Trost shows how effective a good block can be, using Exparel he performs a local block as well as a cord block. He then identifies and delivers the vas, places a vessel loop around it, and uses blunt dissection to obtain 2 cm of length both proximally and distally, freeing up a remarkable amount of vas for the anastomosis through a small midline incision. He also illustrates an interesting technique of using snaps and a drain to provide a secure operative platform.  

    Section Editor James M. Hotaling, MD, MSSection Editor James M. Hotaling, MD, MS

    Dr. Hotaling is assistant professor of surgery (urology) at the Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City.

    To get weekly news from the leading news source for urologists, subscribe to the Urology Times eNews.


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