The impact of obstructive interval and sperm granuloma on outcome of vasectomy reversal

Stephen Boorjian, Michael Lipkin, Marc Goldstein

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)304-306
Number of pages3
JournalJournal of Urology
Volume171
Issue number1
DOIs
StatePublished - Jan 2004
Externally publishedYes

Fingerprint

Vasovasostomy
Pregnancy Rate
Granuloma
Spermatozoa
Vasectomy
Intracytoplasmic Sperm Injections
Fertilization in Vitro
Chi-Square Distribution
Pregnancy

Keywords

  • Granuloma
  • Pregnancy rate
  • Vasectomy
  • Vavovavostomy

ASJC Scopus subject areas

  • Urology

Cite this

The impact of obstructive interval and sperm granuloma on outcome of vasectomy reversal. / Boorjian, Stephen; Lipkin, Michael; Goldstein, Marc.

In: Journal of Urology, Vol. 171, No. 1, 01.2004, p. 304-306.

Research output: Contribution to journalArticle

Boorjian, Stephen ; Lipkin, Michael ; Goldstein, Marc. / The impact of obstructive interval and sperm granuloma on outcome of vasectomy reversal. In: Journal of Urology. 2004 ; Vol. 171, No. 1. pp. 304-306.
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abstract = "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.",
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