Microchirurgische vasovasostomie in het Erasmus MC, 1998-2002: resultaten en voorspellende factoren

To determine the results of microsurgical vasovasostomy procedures with special emphasis on the technical aspects and predictive factors for successful procedures.

Design

Descriptive.

Method

In 1998-2002, 217 vasovasostomy procedures were performed in an outpatients’ clinic setting at the Erasmus MC, Rotterdam, the Netherlands.

Results

Refertilisation was successful in 77 of men and 42 of couples reported a spontaneous pregnancy within one year. The most important predictive factors for a successful outcome were the interval between vasectomy and reversal and the age of the partner. Patency rates were 89 and 62 when the interval was < 5 years and > 15 years, respectively. Rates of spontaneous pregnancy were 56 and 21, respectively. These reductions in rates of patency and pregnancy were attributed primarily to epididymal dysfunction and an increasing interval between vasectomy and reversal. Only 20 of men with a partner aged > 35 years reported spontaneous pregnancies. The risk of secondary epididymal obstruction was 25 after an interval of > 10 years. For these cases, a vasoepididymostomy is needed to achieve patency.

Ned Tijdschr Geneeskd. 2005;149:2743-7