Vasectomy reversal outcomes in men after testosterone therapy

Area of Science:

• Urology
• Reproductive Medicine
• Andrology

Background:

• Increasing prevalence of men on testosterone therapy (TT) seeking vasectomy reversal (VR).
• Previous descriptions of medical therapy (MT) for spermatogenesis recovery post-TT.

Purpose of the Study:

• To present institutional management and outcomes of VR in men previously on TT.
• To evaluate the efficacy of MT in reducing wait times for VR after TT cessation.

Main Methods:

• Retrospective case series of 14 men undergoing VR by a single microsurgeon (March 2010-March 2022).
• Patients had prior TT and subsequent VR, with some receiving MT.
• Analysis of VR outcomes, including patency rates and pregnancy achievement.

Main Results:

• High vasovasostomy (VV) rate (96%) with sustained patency observed.
• Median obstructive interval was 11 years; median time from MT to VR was 5 months.
• Five men with patency achieved pregnancy; two had low sperm counts due to continued TT.

Conclusions:

• Favorable outcomes for VR in men previously on TT, supporting less stringent VV indications post-MT.
• MT effectively reduces recommended wait times for VR after TT discontinuation by over 50%.