The Impact of Obstructive Interval and Sperm Granuloma on Outcome of Vasectomy Reversal

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2004The Impact of Obstructive Interval and Sperm Granuloma on Outcome of Vasectomy Reversal STEPHEN BOORJIAN, MICHAEL LIPKIN, and MARC GOLDSTEIN STEPHEN BOORJIANSTEPHEN BOORJIAN , MICHAEL LIPKINMICHAEL LIPKIN , and MARC GOLDSTEINMARC GOLDSTEIN View All Author Informationhttps://doi.org/10.1097/01.ju.0000098652.35575.85AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We studied the impact of the interval from vasectomy to reversal and presence of sperm granuloma on outcomes of reversal. Materials and Methods: A total of 213 microsurgical vasectomy reversals performed by a single surgeon were stratified according to obstructive intervals of less than 5 years, 5 to 10 years, 10 to 15 years and greater than 15 years. The effects of obstructive interval on patency and pregnancy rates were assessed using multivariate logistical regression. The impact of sperm granuloma on patency and pregnancy was assessed using the chi-square test. Results: Patency did not change with increasing obstructive intervals as can be seen with 91% patency at less than 5 years, 88% at 5 to 10 years, 91% at 10 to 15 and 89% at greater than 15 years. There was no difference in pregnancy rates (89%, 82% or 86%) at obstructive intervals of 0 to 5, 5 to 10 or 10 to 15 years, respectively. Pregnancy rates were significantly lower (44%, p <0.05) with obstructive intervals greater than 15 years. Men with at least unilateral sperm granuloma had patency of 95% vs 78% without granulomas, a trend which did not quite reach statistical significance (p = 0.07). There was no difference in pregnancy rates with or without granulomas. Conclusions: Vasectomy reversal patency rates are high regardless of time since vasectomy. Pregnancy rates are lower more than 15 years after vasectomy. Sperm granuloma had a favorable impact on patency. Our data indicate that for obstructive intervals less than 15 years vasectomy reversal yields much higher pregnancy rates than in vitro fertilization and intracytoplasmic sperm injection, and that even for intervals greater than 15 years reversal outcomes equal or exceed those of in vitro fertilization and intracytoplasmic sperm injection. References 1 : Surgical management of male infertility and other scrotal disorders. In: . Philadelphia: W. B. Saunders Co.2002: 1532. chapt. 44. Google Scholar 2 : Male infertility. In: . Philadelphia: W. B. Saunders Co.2002: 1475. chapt. 43. Google Scholar 3 : Microscopic vasectomy reversal. Fertil Steril1977; 28: 1191. Google Scholar 4 : Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. J Urol1991; 145: 505. Link, Google Scholar 5 : A 20-year experience with vasovasostomy. J Urol1986; 136: 413. 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Google Scholar From the Department of Urology and Institute for Reproductive Medicine, Weill-Cornell University Medical Center, New York, New York© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByNyame Y, Babbar P, Almassi N, Polackwich A and Sabanegh E (2018) Comparative Cost-Effectiveness Analysis of Modified 1-Layer versus Formal 2-Layer Vasovasostomy TechniqueJournal of Urology, VOL. 195, NO. 2, (434-438), Online publication date: 1-Feb-2016.Hayden R and Tanrikut C (2018) Detection and Management of Obstructive AzoospermiaUrology Practice, VOL. 2, NO. 1, (33-37), Online publication date: 1-Jan-2015.Trost L, Parekattil S, Wang J and Hellstrom W (2018) Intracorporeal Robot-Assisted Microsurgical Vasovasostomy for the Treatment of Bilateral Vasal Obstruction Occurring Following Bilateral Inguinal Hernia Repairs with Mesh PlacementJournal of Urology, VOL. 191, NO. 4, (1120-1125), Online publication date: 1-Apr-2014.Fenig D, Kattan M, Mills J, Gisbert M, Yu C and Lipshultz L (2018) Nomogram to Preoperatively Predict the Probability of Requiring Epididymovasostomy During Vasectomy ReversalJournal of Urology, VOL. 187, NO. 1, (215-218), Online publication date: 1-Jan-2012.Hsiao W, Goldstein M, Rosoff J, Piccorelli A, Kattan M, Greenwood E and Mulhall J (2018) Nomograms to Predict Patency After Microsurgical Vasectomy ReversalJournal of Urology, VOL. 187, NO. 2, (607-612), Online publication date: 1-Feb-2012.Hsiao W, Sultan R, Lee R and Goldstein M (2018) Increased Follicle-Stimulating Hormone is Associated With Higher Assisted Reproduction Use After Vasectomy ReversalJournal of Urology, VOL. 185, NO. 6, (2266-2271), Online publication date: 1-Jun-2011.Smit M, Wissenburg O, Romijn J and Dohle G (2018) Increased Sperm DNA Fragmentation in Patients With Vasectomy Reversal Has No Prognostic Value for Pregnancy RateJournal of Urology, VOL. 183, NO. 2, (662-665), Online publication date: 1-Feb-2010.Patel S and Sigman M (2018) Comparison of Outcomes of Vasovasostomy Performed in the Convoluted and Straight Vas DeferensJournal of Urology, VOL. 179, NO. 1, (256-259), Online publication date: 1-Jan-2008.Marmar J, Sharlip I and Goldstein M (2018) Results of Vasovasostomy or Vasoepididymostomy After Failed Percutaneous Epididymal Sperm AspirationsJournal of Urology, VOL. 179, NO. 4, (1506-1509), Online publication date: 1-Apr-2008.Yang G, Walsh T, Shefi S and Turek P (2018) The Kinetics of the Return of Motile Sperm to the Ejaculate After Vasectomy ReversalJournal of Urology, VOL. 177, NO. 6, (2272-2276), Online publication date: 1-Jun-2007.SANDLOW J and KOLETTIS P (2018) VASOVASOSTOMY IN THE CONVOLUTED VAS DEFERENS: INDICATIONS AND OUTCOMESJournal of Urology, VOL. 173, NO. 2, (540-542), Online publication date: 1-Feb-2005. Volume 171Issue 1January 2004Page: 304-306 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsvasectomygranulomavavovavostomypregnancy rateMetricsAuthor Information STEPHEN BOORJIAN More articles by this author MICHAEL LIPKIN More articles by this author MARC GOLDSTEIN More articles by this author Expand All Advertisement PDF DownloadLoading ...