Marco Cosentino1, Maria F Peraza2, Alvaro Vives2, Josvany Sanchez2, Daniel Moreno2, Judith Perona3, Gerardo Ortiz4, Maria Alcoba5, Eduardo Ruiz2, Joaquim Sarquella2. 1. Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain. doccosentino@gmail.com. 2. Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain. 3. Anaesthesia Department, Hospital de Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain. 4. The American British Cowday Medical Center, Ciudad México, DF, Mexico. 5. Urology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
Abstract
PURPOSE: To identify factors predicting success and analyze critically the status of microsurgical double-layer vasovasostomy using predictive models. METHODS: A cohort of 263 patients treated at our institution for vasectomy reversal between 1986 and 2010 was included in our study, and the literature was reviewed. Inclusion criteria were previous bilateral vasectomy and presence of at least two postoperative semen analyses; patients reporting pregnancy without a postoperative semen analysis were excluded. A double-layer, microscope-assisted, tension-free anastomosis vasovasostomy was performed approximating mucosa to mucosa and muscle to muscle with a 10-0 non-absorbable suture. A multivariate logistic regression backward stepwise model was used to predict combined success, and a predictive model was calculated with remaining variables. RESULTS: Mean age was of 41.6 years (SD 7.1); mean duration of obstruction 7.2 years (SD 6.7). On multivariate analysis, uni- or bilateral granuloma and Silber grade of I-III were variable identified predicting higher probability to success (OR 3.105; 95% CI 1.108-8.702; p = 0.031 and OR 4.795; 95% CI 2.117-10.860; p < 0.001, respectively). CONCLUSIONS: Based on our results, some factors predicting success after vasovasostomy surgery are known but others remain unknown; our predictive model may easily predict patency and success after this surgery and offers a concrete assistance in counseling patients.
PURPOSE: To identify factors predicting success and analyze critically the status of microsurgical double-layer vasovasostomy using predictive models. METHODS: A cohort of 263 patients treated at our institution for vasectomy reversal between 1986 and 2010 was included in our study, and the literature was reviewed. Inclusion criteria were previous bilateral vasectomy and presence of at least two postoperative semen analyses; patients reporting pregnancy without a postoperative semen analysis were excluded. A double-layer, microscope-assisted, tension-free anastomosis vasovasostomy was performed approximating mucosa to mucosa and muscle to muscle with a 10-0 non-absorbable suture. A multivariate logistic regression backward stepwise model was used to predict combined success, and a predictive model was calculated with remaining variables. RESULTS: Mean age was of 41.6 years (SD 7.1); mean duration of obstruction 7.2 years (SD 6.7). On multivariate analysis, uni- or bilateral granuloma and Silber grade of I-III were variable identified predicting higher probability to success (OR 3.105; 95% CI 1.108-8.702; p = 0.031 and OR 4.795; 95% CI 2.117-10.860; p < 0.001, respectively). CONCLUSIONS: Based on our results, some factors predicting success after vasovasostomy surgery are known but others remain unknown; our predictive model may easily predict patency and success after this surgery and offers a concrete assistance in counseling patients.
Authors: Peter N Kolettis; Edmund S Sabanegh; Anna M D'amico; Lyndon Box; Michael Sebesta; John R Burns Journal: Urology Date: 2002-11 Impact factor: 2.649
Authors: Sijo J Parekattil; Wayne Kuang; Peter N Kolettis; Fabio F Pasqualotto; Patrick Teloken; Claudio Teloken; Ajay K Nangia; James A Daitch; Craig Niederberger; Anthony J Thomas Journal: J Urol Date: 2006-01 Impact factor: 7.450