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Why does vasectomy reversal fail?

M G Royle, W F Hendry

    British Journal of Urology
    |December 1, 1985
    PubMed
    Summary
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    Repeat vasectomy reversal surgery can restore fertility in azoospermic and oligozoospermic men with vasal or epididymal obstruction. Successful reconstructive surgery led to pregnancies in 37% of azoospermic and some oligozoospermic patients.

    Area of Science:

    • Urology
    • Reproductive Medicine
    • Surgical Innovation

    Background:

    • Vasectomy reversal failure can lead to persistent infertility.
    • Azoospermia and oligozoospermia are common after failed vasectomy reversal.
    • Surgical exploration of the scrotum is crucial for diagnosing persistent infertility.

    Purpose of the Study:

    • To evaluate the efficacy of repeat surgical interventions for infertility following vasectomy reversal.
    • To identify causes of persistent infertility after vasectomy reversal.
    • To assess pregnancy rates after reconstructive surgery for vasal and epididymal obstruction.

    Main Methods:

    • Scrotal exploration was performed in 32 patients with failed vasectomy reversal.
    • Surgical procedures included repeat vaso-vasostomy and epididymo-vasostomy.
    Keywords:
    AnatomyBiologyEpididymisEvaluationExaminations And DiagnosesFamily PlanningGenitaliaGenitalia, MaleHistologyLaboratory Examinations And DiagnosesLaboratory ProceduresPhysical Examinations And DiagnosesPhysiologyReversibilityReversible SterilizationSperm Count--analysisSterilization ReversalSterilization, SexualTestisUrogenital SystemVas Reanastomosis

    Related Experiment Videos

  • Antisperm antibody titres were assessed, and prednisolone therapy was administered in select cases.

    • Main Results:

    • In azoospermic patients, 12/23 had vasal blockage; 10/12 achieved normal sperm counts post-repeat vaso-vasostomy, with 8 pregnancies.
    • Four cases had secondary epididymal block; 3/4 achieved normal sperm counts post-epididymo-vasostomy, with 2 pregnancies.
    • High antisperm antibody titres (>/=1024) correlated with poor pregnancy outcomes (0/7 pregnancies).
    • In oligozoospermic patients, 8/9 had unilateral obstruction; 4/8 achieved normal sperm counts post-surgery, with 1 pregnancy.

    Conclusions:

    • Repeat reconstructive surgery is effective for vasal and epididymal obstruction post-vasectomy reversal.
    • High antisperm antibody titres significantly impair fertility outcomes.
    • Surgical intervention offers a viable option for selected infertile men after vasectomy reversal.