Surgical Outcome of 153 Vasovasostomies on 10 Years or More after Vasectomy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: In the 1970s, male sterilization (vasectomy) has been performed on a large scale as an accepted method of family planning in Korea. Since then, especially during last decade, there has been an increase in the number of patients requesting vasovasostomy after a long term interval following a vasectomy. MATERIALS AND METHODS: We evaluated 153 cases of vasovasostomy performed, 10 years or more after a vasectomy, at the Pusan National University Hospital between March 1983 and March 2002. Clinical data were collected through telephone interviews and a survey of medical records. RESULTS: The ages at the time of reversal ranged from 30 to 57, with an average of 41.6 years. The obstructive intervals ranged from 10 to 24, with an average of 17.0 years. To the cases were divided into 3 the obstructive intervals; 10 to 14, 15 to 19 and 20 to 24 years, with 130 (85.0%), 15 (9.8%) and 8 cases (5.2%), respectively. The overall patency and pregnancy rates were 81.6 and 36.0%, respectively. There were no significant differences according to the methods of vasovasostomy, suture materials, ooze from the proximal vasal end, the presence of sperm granuloma, the levels of anastomosis or the age of patients, with the exception of the ages of the partners in the patency and pregnancy rates for the patients with vasovasostomy 10 years or more after vasectomy. CONCLUSIONS: Our results suggest that the pregnancy rates after vasovasostomies, following at least a 10 years long term obstruction, are very low, despite the desirable patency rates. Therefore, it is important that we should apply the assisted reproductive technology, as well as advanced surgical skills, to improve the pregnancy rates.