Patency following vasectomy reversal. Temporal and immunological considerations

Saudi Med J. 2005 Aug;26(8):1208-11.

Abstract

Objectives: To evaluate the postoperative patency rates of microsurgical vasovasostomy and vasoepididymostomy at various vasectomy reversal time intervals, and to assess the implications of anti-sperm antibodies on results.

Methods: Three hundred and eighty-two patients underwent unilateral or bilateral vasectomy reversal between January 1997 and April 2001 at the Health Clinic, Highgate and Manor House Hospitals, London, United Kingdom. Patients were divided into 4 groups according to the time interval between vasectomy and reversal; less than 5 years, 5-10 years, 10-15 years, and more than 15 years. Data collected included patient's age at time of vasectomy reversal, seminal fluid analysis at 3, 6 and 12 months after surgery, and the presence or absence of anti-sperm antibodies before vasectomy reversal.

Results: Mean patient age at the time of reversal was 44.6 years. The mean vasectomy reversal time interval was 12.8 years. Overall patency rate of the patients groups was 62.9% with positive sperm in the ejaculate in 85.3% in the less than 5 years group, 75.3% in the 5-10 years group, 50.3% in the 10-15 years group and 26.9% in the more than 15 years group. Anti-sperm antibodies were positive in 31 patients (9.1%), of whom 12 patients (38.7%) were positive for sperm in the ejaculate.

Conclusion: Microsurgical vasectomy reversal produces satisfactory patency rates to couples that consider reestablishing their fertility even more than 15 years after vasectomy. The presence of anti-sperm antibodies is associated with negative effects on sperm count, motility, and percentage of abnormal forms.

MeSH terms

  • Adult
  • Antibodies / blood
  • Humans
  • Male
  • Microsurgery
  • Middle Aged
  • Retrospective Studies
  • Sperm Count
  • Spermatozoa / immunology
  • Time Factors
  • Treatment Outcome
  • Vas Deferens / physiopathology
  • Vasovasostomy*

Substances

  • Antibodies