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The Kinetics Of The Return Of Motile Sperm To The Ejaculate After Vasectomy Reversal

May 09, 2017

UroToday - The authors investigate the factors that predict not success of vasectomy reversal but the time course or the "kinetics" of the return of sperm to the ejaculate.

They point out that that previously, success was judged is patency or return of sperm to the ejaculate. Time of return is an important variable that may affect treatment choices. They hypothesized that there are clinical and intraoperative predictors of time to success.

A retrospective cohort study was performed assessing patient demographics, semen analyses, and intraoperative surgical findings. "Patency" was defined as the presence of motile sperm in the ejaculate. 152 patients were included in the study. Eighty-four patients had bilateral vasovasostomy (VV), 23 had bilateral epididymovasostomy (EV), and 34 had a VV/EV combination.

The presence of motile sperm at both vasa at time of reconstruction predicted significantly faster patency rates postoperatively. 95% of those patients with motile sperm at reconstruction achieved patency by 6 months, whereas 76% of patients without motile sperm achieved patency within 6 months (p=0.04). By 6 months, 81% of patients with bilateral VV or mixed VV/EV achieved patency, compared to 31% of patients with bilateral EV (p