[Microsurgical vasovasostomy at the Erasmus MC, 1998-2002: results and predictive factors]

To determine the results ofmicrosurgical vasovasostomy procedures with special emphasis on the technical aspects and predictive factors for successful procedures.

Descriptive.

In 1998-2002, 217 vasovasostomy procedures were performed in an outpatients' clinic setting at the Erasmus MC, Rotterdam, The Netherlands.

Refertilisation was successful in 77% of men and 42% of couples reported a spontaneous pregnancy within one year. The most important predictive factors for a successful outcome were the interval between vasectomy and reversal and the age of the partner. Patency rates were 89% and 62% when the interval was < 5 years and > 15 years, respectively. Rates of spontaneous pregnancy were 56% and 21%, respectively. These reductions in rates of patency and pregnancy were attributed primarily to epididymal dysfunction and an increasing interval between vasectomy and reversal. Only 20% of men with a partner aged > 35 years reported spontaneous pregnancies. The risk of secondary epididymal obstruction was 25% after an interval of > 10 years. For these cases, a vasoepididymostomy is needed to achieve patency.