Factors and practice patterns that affect the decision for vasoepididymostomy

Kevin A. Ostrowski, Nicholas N. Tadros, A. Scott Polackwich, R. Dale McClure, Eugene Fuchs, Jason Hedges

Research output: Contribution to journalArticle

Abstract

Introduction: To determine the factors used to make the decision between vasovasostomy (VV) and vasoepididymostomy (VE) by leaders performing microsurgical vasectomy reversal using a questionnaire. Materials and methods: An online questionnaire was sent to all members of the Society for the Study of Male Reproduction (SSMR), a male reproduction subspecialty society of the AUA, using the SurveyMonkey platform. Results: Sixty-seven surgeons responded to the questionnaire (27% of SSMR members). Of which 72% of members performed less than 50 vasectomy reversals per year. Also, 71% of members stated that less than 20% of their vasectomy reversals are vasoepididymostomies. When evaluating epididymal fluid at the time of reversal, 87% would perform a VE for pasty fluid, 66% with creamy fluid without sperm heads and 55% with no or scant fluid. With respect to banking sperm, 36% take sperm or testicular tissue at the time of VE while 37% sometimes take sperm mostly depending on the couple's preference. The Berger end-to-side with intussusception VE technique is used by the majority of members (78%). The presence of intact sperm or sperm parts determined the location in the epididymis for anastomosis for 55% and 19% of members respectively. Postoperative semen testing after a VE is evaluated first between 6 weeks to 3 months for 64%. The procedure is considered a failure between 6 to 12 months for 34% and 12 to 18 months for another 48% if no sperm is seen on semen analysis. Conclusions: Most members perform a VE with pasty fluid or creamy fluid without sperm heads. Three out of four members are using the Berger end-to-side intussusception technique to perform their VE. More studies are needed to determine the optimal circumstances to perform a VE as there is significant variation in responses even among members of the SSMR.

Original languageEnglish (US)
Pages (from-to)8651-8655
Number of pages5
JournalCanadian Journal of Urology
Volume24
Issue number1
StatePublished - 2017

Fingerprint

Vasovasostomy
Spermatozoa
Reproduction
Sperm Head
Intussusception
Semen Analysis
Epididymis
Semen
Surveys and Questionnaires

Keywords

  • Infertility
  • Male reproduction
  • Practice patterns
  • Vasectomy reversal
  • Vasoepididymostomy

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

Cite this

Ostrowski, K. A., Tadros, N. N., Polackwich, A. S., McClure, R. D., Fuchs, E., & Hedges, J. (2017). Factors and practice patterns that affect the decision for vasoepididymostomy. Canadian Journal of Urology, 24(1), 8651-8655.

Factors and practice patterns that affect the decision for vasoepididymostomy. / Ostrowski, Kevin A.; Tadros, Nicholas N.; Polackwich, A. Scott; McClure, R. Dale; Fuchs, Eugene; Hedges, Jason.

In: Canadian Journal of Urology, Vol. 24, No. 1, 2017, p. 8651-8655.

Research output: Contribution to journalArticle

Ostrowski, KA, Tadros, NN, Polackwich, AS, McClure, RD, Fuchs, E & Hedges, J 2017, 'Factors and practice patterns that affect the decision for vasoepididymostomy', Canadian Journal of Urology, vol. 24, no. 1, pp. 8651-8655.
Ostrowski, Kevin A. ; Tadros, Nicholas N. ; Polackwich, A. Scott ; McClure, R. Dale ; Fuchs, Eugene ; Hedges, Jason. / Factors and practice patterns that affect the decision for vasoepididymostomy. In: Canadian Journal of Urology. 2017 ; Vol. 24, No. 1. pp. 8651-8655.
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abstract = "Introduction: To determine the factors used to make the decision between vasovasostomy (VV) and vasoepididymostomy (VE) by leaders performing microsurgical vasectomy reversal using a questionnaire. Materials and methods: An online questionnaire was sent to all members of the Society for the Study of Male Reproduction (SSMR), a male reproduction subspecialty society of the AUA, using the SurveyMonkey platform. Results: Sixty-seven surgeons responded to the questionnaire (27{\%} of SSMR members). Of which 72{\%} of members performed less than 50 vasectomy reversals per year. Also, 71{\%} of members stated that less than 20{\%} of their vasectomy reversals are vasoepididymostomies. When evaluating epididymal fluid at the time of reversal, 87{\%} would perform a VE for pasty fluid, 66{\%} with creamy fluid without sperm heads and 55{\%} with no or scant fluid. With respect to banking sperm, 36{\%} take sperm or testicular tissue at the time of VE while 37{\%} sometimes take sperm mostly depending on the couple's preference. The Berger end-to-side with intussusception VE technique is used by the majority of members (78{\%}). The presence of intact sperm or sperm parts determined the location in the epididymis for anastomosis for 55{\%} and 19{\%} of members respectively. Postoperative semen testing after a VE is evaluated first between 6 weeks to 3 months for 64{\%}. The procedure is considered a failure between 6 to 12 months for 34{\%} and 12 to 18 months for another 48{\%} if no sperm is seen on semen analysis. Conclusions: Most members perform a VE with pasty fluid or creamy fluid without sperm heads. Three out of four members are using the Berger end-to-side intussusception technique to perform their VE. More studies are needed to determine the optimal circumstances to perform a VE as there is significant variation in responses even among members of the SSMR.",
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AU - Fuchs, Eugene

AU - Hedges, Jason

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AB - Introduction: To determine the factors used to make the decision between vasovasostomy (VV) and vasoepididymostomy (VE) by leaders performing microsurgical vasectomy reversal using a questionnaire. Materials and methods: An online questionnaire was sent to all members of the Society for the Study of Male Reproduction (SSMR), a male reproduction subspecialty society of the AUA, using the SurveyMonkey platform. Results: Sixty-seven surgeons responded to the questionnaire (27% of SSMR members). Of which 72% of members performed less than 50 vasectomy reversals per year. Also, 71% of members stated that less than 20% of their vasectomy reversals are vasoepididymostomies. When evaluating epididymal fluid at the time of reversal, 87% would perform a VE for pasty fluid, 66% with creamy fluid without sperm heads and 55% with no or scant fluid. With respect to banking sperm, 36% take sperm or testicular tissue at the time of VE while 37% sometimes take sperm mostly depending on the couple's preference. The Berger end-to-side with intussusception VE technique is used by the majority of members (78%). The presence of intact sperm or sperm parts determined the location in the epididymis for anastomosis for 55% and 19% of members respectively. Postoperative semen testing after a VE is evaluated first between 6 weeks to 3 months for 64%. The procedure is considered a failure between 6 to 12 months for 34% and 12 to 18 months for another 48% if no sperm is seen on semen analysis. Conclusions: Most members perform a VE with pasty fluid or creamy fluid without sperm heads. Three out of four members are using the Berger end-to-side intussusception technique to perform their VE. More studies are needed to determine the optimal circumstances to perform a VE as there is significant variation in responses even among members of the SSMR.

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