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Early Vasectomy Reversal Experience and Outcomes of Fellowship-Trained Microsurgeons Daniel H Williams IV, Edward Karpman, Ethan D Grober, Christopher G Schrepferman, Donald S Crain, Weber W Chuang, David Shin, Mohit Khera, Wayne Kuang, Cigdem Tanrikut. AUA Annual Meeting

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Early Vasectomy Reversal Experience and Outcomes of

Fellowship-Trained Microsurgeons

Daniel H Williams IV, Edward Karpman, Ethan D Grober, Christopher G Schrepferman, Donald S Crain,

Weber W Chuang, David Shin, Mohit Khera, Wayne Kuang, Cigdem Tanrikut

AUA Annual Meeting

April 2009, Chicago, IL

Poster #2011

  • Methods
  • Patient records from the first two years of clinical practice were retrospectively reviewed.
  • The following data points were recorded for each microsurgeon:
    • Number of vasectomy reversals
    • Type of reversal performed
    • Post-operative semen parameters (if available)
  • Each urologist had completed a minimum one-year clinical fellowship in male reproductive medicine and microsurgery.
  • Introduction
  • Surgical volume and experience have been shown to correlate with favorable post-operative outcomes in a variety of surgical specialties and in urological surgery.1,2
  • Newly-graduated surgical trainees lack such years of independent experience.
  • However, it is unknown to what extent this inexperience affects their early surgical outcomes (given previous sound surgical training).
  • Results
  • In their first 2 years of practice, 10 microsurgeons performed 310 microsurgical vasectomy reversals (range 1-75).
  • 221 bilateral vasovasostomies (VV)
  • 59 unilateral vasovasostomy with unilateral epididymovasostomy (VV/EV)
  • 30 bilateral epididymovasostomies (EV)
  • Post-operative semen analyses were available for 236 (76.1%) patients.
  • The overall patency rate was 90.7% (214 of 236). Patency rates for VV, VV/EV, and EV were 96%, 87.5%, and 54%, respectively.

Conclusions

Overall, vasectomy reversal patency rates in this study are consistent with those reported by experienced urologists performing microsurgical vasectomy reversals (VV 87%, VV/EV 70%, EV 50%).3

Recent completion of fellowship training by microsurgeons in this group did not seem to have a negative impact on vasectomy reversal patency rates.

These findings highlight the importance of good microsurgical training prior to independent clinical practice.

  • Objective
  • The primary objective of this study was to evaluate early vasectomy reversal experience and outcomes of fellowship-trained microsurgeons in their first two years of clinical practice.
  • Limitations
  • Relatively small sample size
  • Individual surgical techniques may influence outcomes
  • Short-term follow-up without pregnancy data
  • References
  • Hellawell et al. Urology 2008; 72(6): 1347-50
  • Rosser et al. Cancer 2006; 107: 54-59
  • Belker et al. J Urol 1991; 145: 505-511

3

  • Sources of Funding
  • None
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