Document Detail


The impact of obstructive interval and sperm granuloma on outcome of vasectomy reversal.
MedLine Citation:
PMID:  14665900     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Stephen Boorjian; Michael Lipkin; Marc Goldstein
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  171     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-10     Completed Date:  2004-01-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  304-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Urology and Institute for Reproductive Medicine, Weill-Cornell University Medical Center, New York, New York, USA. stb9009@nyp.org
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MeSH Terms
Descriptor/Qualifier:
Female
Granuloma*
Humans
Male
Pregnancy / statistics & numerical data
Retrospective Studies
Spermatozoa*
Time Factors
Vasovasostomy*
Comments/Corrections
Comment In:
J Urol. 2004 Jan;171(1):310   [PMID:  14665902 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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