Vasectomy Reversal: A Seven-Year Experience

Original Paper
Urol Int 399
DOI: 10.1159/000XXXXXX
Vasectomy Reversal: A Seven-Year
Experience
Wilson F.S. Busato, Jr.
Instituto Catarinense de Urologia, Medical School, Itajai Valley University (UNIVALI), Itajai , Brazil
Introduction
More than 30 million couples throughout the world
use vasectomy as a method of birth control. It is estimated
that up to 6% of men who undergo vasectomy will seek
for reversal [1] and 3.5% will in fact receive a vasovasostomy
[2] . In the USA, about 600,000 to 1 million vasectomies
are performed annually, resulting in an estimated
21,000–35,000 reversals [3] . In Brazil, available data underestimate
the real situation since vasectomy and vasectomy
reversal costs are not covered by health insurance
programs or by the public health system. As a result, in
this country the series have a low number of patients [4] .
Recent studies show that between 2.6 and 10% of couples
favors vasectomy [4] .
Success rates have to be compared between vasectomy
reversal and intracytoplasmic sperm injection (ICSI)
combined with microscopic epididymal sperm aspiration
(MESA) procedures. However, it has been demonstrated
that the reversal procedure has a higher rate of
success, lower costs and provides the possibility of more
than one pregnancy at the couple’s own convenience [5–
7] . Even whether vasoepididymostomy is necessary, the
reversal procedure is more cost-effective compared to
MESA [6, 8] . There are some factors that help to determine
the reversal success such as the time interval since
vasectomy, secretion of a thick fluid at the proximal end
of the vas deferens and the presence of sperm granulomas
at the anastomosis site [9, 10] . Nevertheless, factors related
to population characteristics may be important for
Key Words
Male infertility Pregnancy Vasectomy Vasovasostomy
Microsurgery
Abstract
Introduction: Since the demand for vasectomy reversal is
increasing and many populations in Brazil and other countries
show distinct characteristics, this study was carried out
as an effort to determine factors and characteristics associated
with the success rate of reversal in a population in
Southern Brazil. Patients and Methods: We reviewed 29 cases
of vasectomy reversal performed over a 7-year period using
the single-layer technique under microscopic magnification.
Results: Mean patency, pregnancy, and birth rates were
75, 41.7 and 29%, respectively. The patency and pregnancy
rates were 92.3 and 38.5%, respectively, for time intervals
since vasectomy ! 10 years and 63.6 and 45.4%, respectively,
for intervals 1 10 years. Patency and pregnancy rates were
87.5 and 50%, respectively, for patients who had their vasectomy
performed by a urologist, and 50 and 25%, respectively,
for those who had their vasectomy performed by a generalist
surgeon (p ! 0.05). Conclusions: High patency and
pregnancy rates are associated with time intervals since vasectomy
of ! 10 years and vasectomies performed by urologists.
There was no significant difference in the anastomosis
time between the first 12 procedures and the next 12 procedures.
Copyright © 2008 S. Karger AG, Basel
Received: July 2, 2007
Accepted after Internationalis revision: December 27, 2007
Urologia

Informativo

hoje comemoramos o dia do médico , dia do Pintor e dia do Securitário !!
a todos nossos parabéns !!!

a todos uma ótima semana.