1994 VASECTOMY REVERSAL OUTCOMES AMONG PATIENTS WITH VASAL OBSTRUCTIVE INTERVALS OF GREATER THAN 10 YEARS

Abstract

You have accessJournal of UrologyInfertility: Therapy1 Apr 20121994 VASECTOMY REVERSAL OUTCOMES AMONG PATIENTS WITH VASAL OBSTRUCTIVE INTERVALS OF GREATER THAN 10 YEARS Ethan Grober, Edward Karpman, and Majid Fanipour Ethan GroberEthan Grober Toronto, Canada More articles by this author , Edward KarpmanEdward Karpman Mountain View, CA More articles by this author , and Majid FanipourMajid Fanipour Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2155AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The vasal obstructive time has been shown to be a significant predictor of outcome following vasectomy reversal. While no strict time cut off exists, frequently couples are discouraged from considering a vasectomy reversal strictly based on the time from vasectomy. The objective of the current study was to analyze vasectomy reversal outcomes specifically among patients with vasal obstructive intervals of greater than 10 years. METHODS From 2006 to 2011, all consecutive vasectomy reversals performed by 2 fellowship-trained microsurgeons were analyzed. Cases were stratified into 4 categories based on the duration of the vasal obstructive interval: <10 years, 10-15 years, 15-20 years, >20 years. Post-operative semen quality, patency rates and pregnancy outcomes were compared among the groups. RESULTS Of 535 consecutive vasectomy reversals, 177 (33%) patients had a vasal obstructive interval of greater than 10 years. Couple characteristics, type of vasectomy reversal (VV or VE), post-operative semen quality, patency and pregnancy rates among the groups are summarized in Table 1. While the vasal obstructive interval influenced the type of reversal indicated, favorable semen parameters, patency and pregnancy rates were achieved in men over 10 years from vasectomy (Table 1). Men with longer vasal obstructive intervals were older (p<0.001) and had older female partners (p=0.006) and therefore female reproductive health may ultimately influence pregnancy rates in this group. Table 1. Obstructive Time Interval <10 years (n=358) 10-15 years (n=104) >15-20 years (n=53) >20 years (n=20) Male Age VR (years) 38 43 48 55 Female age VR (years) 33 32 36 36 Type of VR (%) •VV/VV 83 64 62 50 •VV/VE 11 21 21 30 •VE/VE 6 15 17 20 % Patent 95% 87% 94% 92% % Pregnant (>1 year follow up) 40% 26% 39% 24% Semen Quality 33 32 36 36 •Sperm Concentration (mil/ml) 36 22 34 34 •% Motile 38% 27% 23% 21% •% Normal Morphology 43% 39% 33% 23% CONCLUSIONS While the time since vasectomy has a significant impact on the type of vasectomy reversal required (VV or VE), provided a surgeon is proficient with VV and VE, favorable semen parameters, patency and pregnancy rates can be achieved in men over 10 years from vasectomy. Couples should not be discouraged from considering vasectomy reversal simply based on the vasal obstructive interval. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e804 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ethan Grober Toronto, Canada More articles by this author Edward Karpman Mountain View, CA More articles by this author Majid Fanipour Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...