Ethan D Grober1, Edward Karpman2, Majid Fanipour3. 1. Division of Urology, Department of Surgery, Mount Sinai and Women's College Hospital, University of Toronto, Toronto, ON, Canada. Electronic address: egrober@mtsinai.on.ca. 2. El Camino Urology, Mountain View, CA. 3. Division of Urology, Department of Surgery, Mount Sinai and Women's College Hospital, University of Toronto, Toronto, ON, Canada.
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.
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.
Authors: Ujval S Pathak; Adithya Balasubramanian; Jonathan A Beilan; Mohit Butaney; Alexander J Tatem; Nannan Thirumavalavan; Larry I Lipshultz Journal: Transl Androl Urol Date: 2019-12
Authors: Marcelo Marconi; José Manuel de la Torre; Cristian Palma; Hector Gallegos; Evelyn Soto; Sebastián Celis; Camila de la Torre; Carolina Ortiz; Alberto Duarte; Ignacio Idalsoaga Journal: Open Vet J Date: 2019-11-29