Vasectomy reversal outcomes among patients with vasal obstructive intervals greater than 10 years - Abstract

OBJECTIVE: To analyze the vasectomy reversal (VR) outcomes specifically among patients with vasal obstructive intervals (VOIs) of >10 years.

The VOI has been shown to be a significant predictor of outcome after VR. Although no strict cutoff exists, couples have frequently been discouraged from considering a VR strictly according to the interval from vasectomy.

MATERIALS AND METHODS: From 2006 to 2011, all consecutive VRs performed by 2 fellowship-trained microsurgeons were analyzed. The patients were stratified into 4 categories according to the duration of the VOI: < 10, 10-15, >15-20, and >20 years. The postoperative semen parameters, patency rates, and pregnancy outcomes were compared among the 4 groups.

RESULTS: Of 535 consecutive VRs, 177 patients (33%) had a VOI of >10 years. The couple characteristics, type of VR required, postoperative semen quality, and patency and pregnancy rates among the 4 groups were analyzed. The men with longer VOIs were older (P < .001) and had older female partners (P = .006). Although the VOI influenced the type of reversal performed, favorable semen concentrations (average >20 million/mL in all groups) and patency (average >90%) and pregnancy rates (range 24%-39%) were achieved in men with a VOI >10 years.

CONCLUSION: Although the interval since vasectomy has a significant effect on the type of VR required, provided a surgeon is proficient in both microsurgical vasovasostomy and vasoepididymostomy, favorable semen parameters and patency and pregnancy rates can be achieved in men with a VOI >10 years. Couples should not be discouraged from considering VR simply according to the VOI.

Written by:
Grober ED, Karpman E, Fanipour M.   Are you the author?
Division of Urology, Department of Surgery, Mount Sinai and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Reference: Urology. 2013 Nov 6. pii: S0090-4295(13)01179-5.
doi: 10.1016/j.urology.2013.09.016

PubMed Abstract
PMID: 24210560 Vasectomy Section