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Failed vasectomy reversal: is a further attempt using microsurgery worthwhile?

M Fox1

  • 1Claremont Hospital, Sheffield, UK.

BJU International
|September 6, 2000
PubMed
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Microsurgical vasovasostomy offers a good chance of fertility after failed vasectomy reversal, even years later. Sperm in the ejaculate was restored in 57% of patients, with 32% achieving paternity.

Area of Science:

  • Urology
  • Reproductive Medicine
  • Microsurgery

Background:

  • Vasectomy reversal can fail due to anastomotic obstruction.
  • Microsurgery offers a potential solution for failed vasectomy reversals.

Purpose of the Study:

  • To evaluate the effectiveness of microsurgical revision for failed vasectomy reversal.
  • To correlate outcomes with surgical site, time since vasectomy, and intraoperative sperm presence.

Main Methods:

  • A microsurgical oblique end-to-end anastomosis was performed on 28 patients with confirmed obstruction.
  • Seminal analysis and paternity were assessed post-surgery and compared to primary reversals.

Main Results:

  • Sperm returned to ejaculate in 57% of patients; 32% achieved paternity.

Related Experiment Videos

  • Success rates decreased with time since vasectomy but remained possible even after 10 years.
  • Presence of sperm in the vas at surgery correlated with ejaculate sperm, but absence did not preclude success.

    • Conclusions:

    • Microsurgical vasovasostomy provides a viable option for fertility after prior reversal failure.
    • Time since vasectomy impacts success, but prolonged intervals can still yield positive results.
    • Absence of sperm intraoperatively doesn't guarantee failure; however, thick creamy fluid predicts poor outcomes.