Vasovasostomies in Men 15 Years or More after Vasectomy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: This study aimed to evaluate the results of vasovasostomies performed in men 15 years or more after a vasectomy. MATERIALS AND METHODS: Vasovasostomies were performed in 39 men 15 years or more after a vasectomy using a two-layer microscopic technique. The medical charts of the subjects were reviewed with regard to the age of the patients and their wives, the presence of sperm in vasal fluid and the gross appearance of the vasal fluid (watery, milky or creamy) during operation. The postoperative follow-up consisted of serial semen analyses and telephone interviews. RESULTS: The patency and pregnancy rates were 73.7 and 30%, respectively. Patients whose vasal fluid was watery or milky during operation had better patency rates (p=0.049). Other factors, including age of patients, obstructive interval and intraoperative detection of sperm, had no influence on the patency rates. When their wives were divided according to age (above and below 37 years), the pregnancy rates were 70 and 18% in the younger and older age groups, respectively (p=0.03). CONCLUSIONS: The rate of success of a vasectomy reversal in men 15 years or more after their vasectomy was lower than those whose vasectomies were performed more recently, but compared favorably with those obtained with assisted reproductive technology. We recommend that a microsurgical vasovasostomy should be performed preferentially in men 15 years or more after their vasectomy.