📃 Paper Title: Patency Following Microsurgical Vasoepididymostomy and Vasovasostomy: Temporal considerations
🧍 Author: Matthews
🕒 Year: 1995
📚 Journal: The Journal of Urology
🌎 Country: USA
ㅤContext to the study:
Can you tell me about a study that assessed the patency following microsurgical vasoepididymostomy vs vasovasostomy?
ㅤ✅ Take-home message of study:
Microsurgical vasovastomy has a higher patency rate (99% vs 65%) that vasoepididymostomy and a lower failure rate (12% vs 21%). The return of motile sperm is quicker with vasovasostomy (+/- 2months vs +/- 6months), with higher pregnancy rates (52% vs 21%).
Further intervention for persistent azoospermia is appropriate after 6 months for vasovasostomy and 12 months for vasepididymostomy.
ㅤ Retrospective, single surgeon study
ㅤ
Study participants:
Study size and inclusion criteria:
200 men who underwent vasovasostomy (100) or vasoepididymostomy (100) by a single surgeon between February 1988 and February 1994
All men were azoospermic pre-operatively but had normal sperm present in the efflux of at least 1 afferent anastamotic limb of the vas.
The minimum follow-up was 12 months - men were followed up until the couple was able to conceive.
ㅤ
ㅤ
Key study outcomes:
Microsurgical vasovasostomy has a patency rate of 99% in this study.
The time taken for motile sperm to return to the ejaculate in men undergoing microsurgical vasovasotomy was approximately 2 months.
Pregnancy rates were 52% and late failure rate was 12%
Microsurgical Vasoepididymostomy had a patency rate of 65% in this study.
The time taken for motile sperm to return to the ejaculate in men undergoing microsurgical vasoepididymostomy was approximately 6 months.
Pregnancy rates were 21% and late failure rate was 21%
ㅤ
ㅤ
Study Limitations:
Single surgeon study with technique specified by the operating surgeon
Pre-operative semen analysis not fully reported.
Data is limited to men with intact sperm in at least 1 afferent anastomotic limb
Anastamosis performed in the absence of intact sperm were not included in this study
Success of treatment was measured in pregnancies, follow up was only 5 years post-op
Late failure is a possibility
ㅤ