Patency following microsurgical vasoepididymostomy and vasovasostomy: temporal considerations.

Abstract

We evaluate the temporal parameters of patency following vasoepididymostomy and vasovasostomy. A series of consecutive and concurrent vasoepididymostomies (100) and vasovasostomies (100) performed by a single surgeon (M. G.) was reviewed. Patency rates following vasoepididymostomy and vasovasostomy were 65% and 99%, respectively (p < 0.001). Motile sperm were observed at a mean of 5.8 +/- 0.8 months (standard error) following vasoepididymostomy and 2.1 +/- 0.2 months following vasovasostomy (p < 0.01). Late failure rates were 21% for vasoepididymostomy and 12% for vasovasostomy. Pregnancy rates following vasoepididymostomy and vasovasostomy were 21% and 52%, respectively. Patency is rapid following vasovasostomy but requires 12 or more months following vasoepididymostomy. Intervention for azoospermia is appropriate 6 months after vasovasostomy and 1 year after vasoepididymostomy. Intraoperative cryopreservation of sperm in men undergoing vasoepididymostomy and postoperatively in all men with motile sperm will maximize fertility options.