The Pattern of Semen Quality Recovery After Three Different Types of Vasectomy Reversal Procedures
S Cayan, A Hernandez, and PJ Turek
Department of Urology, University of California
San Francisco, San Francisco, CA.
Objective
How semen quality changes with time after vasectomy reversal is not well understood. This information could better inform our understanding of post-obstructive reproductive tract physiology and also assist clinicians in patient counseling about vasectomy reversal. We examined how semen quality changes with time after vasectomy reversal.
Design
Retrospective, case controlled study; single center experience.
“…The pattern of change in semen quality with time after vasectomy appears to differ with the type of procedure.”
– Dr. Paul Turek
Materials and Methods
From the last 100 vasectomy reversals, patients were identified who had at least four semen analyses and were followed for at least 1 year after surgery. Vasectomy reversal procedures includedbilateral vasovasostomy (Bil. VV), unilateral vasovasostomy with unilateral epididymovasostomy (VV/EV) and bilateral epididymovasostomy (Bil. EV). For procedure type, semen analysis data were pooled for each 3-month interval after surgery and total motile sperm counts (TMC) were calculated. Mean TMC at each time interval is reported. From the last 100 vasectomy reversals, patients were identified who had at least four semen analyses and were followed for at least 1 year after surgery. Vasectomy reversal procedures included bilateral vasovasostomy (Bil. VV), unilateral vasovasostomy with unilateral epididymovasostomy (VV/EV) and bilateral epididymovasostomy (Bil. EV). For procedure type, semen analysis data were pooled for each 3-month interval after surgery and total motile sperm counts (TMC) were calculated. Mean TMC at each time interval is reported.
Results
Among 100 patients, 36 fulfilled the inclusion criteria. Among this cohort, no pregnancies were achieved during the 12 month follow-up period. The pattern of change in semen quality with procedure type is shown below: (see graph in downloadable PDF)
Conclusion
The pattern of change in semen quality with time after vasectomyappears to differ with the type of procedure. Whether these differences are related to the anatomical nature of the surgical reanostomosis or reflective of alterations in epididymal physiology is unclear, but worthy of speculation and further study.
