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Factors predicting success after microsurgical vasovasostomy

  • Urology - Original Paper
  • Published:
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Abstract

Purpose

To identify factors predicting success and analyze critically the status of microsurgical double-layer vasovasostomy using predictive models.

Methods

A cohort of 263 patients treated at our institution for vasectomy reversal between 1986 and 2010 was included in our study, and the literature was reviewed. Inclusion criteria were previous bilateral vasectomy and presence of at least two postoperative semen analyses; patients reporting pregnancy without a postoperative semen analysis were excluded. A double-layer, microscope-assisted, tension-free anastomosis vasovasostomy was performed approximating mucosa to mucosa and muscle to muscle with a 10-0 non-absorbable suture. A multivariate logistic regression backward stepwise model was used to predict combined success, and a predictive model was calculated with remaining variables.

Results

Mean age was of 41.6 years (SD 7.1); mean duration of obstruction 7.2 years (SD 6.7). On multivariate analysis, uni- or bilateral granuloma and Silber grade of I–III were variable identified predicting higher probability to success (OR 3.105; 95% CI 1.108–8.702; p = 0.031 and OR 4.795; 95% CI 2.117–10.860; p < 0.001, respectively).

Conclusions

Based on our results, some factors predicting success after vasovasostomy surgery are known but others remain unknown; our predictive model may easily predict patency and success after this surgery and offers a concrete assistance in counseling patients.

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Abbreviations

VSG:

Vasovasostomy study group

VV:

Vasovasostomy

VE:

Vasoepididymostomy

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Acknowledgements

To Cristina Esquinas Lopez for statistical analysis and for her patience.

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Authors and Affiliations

  1. Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain

    Marco Cosentino, Maria F. Peraza, Alvaro Vives, Josvany Sanchez, Daniel Moreno, Eduardo Ruiz & Joaquim Sarquella

  2. Anaesthesia Department, Hospital de Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain

    Judith Perona

  3. The American British Cowday Medical Center, Ciudad México, DF, Mexico

    Gerardo Ortiz

  4. Urology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Maria Alcoba

Authors
  1. Marco Cosentino
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  2. Maria F. Peraza
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  3. Alvaro Vives
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  4. Josvany Sanchez
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  5. Daniel Moreno
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  6. Judith Perona
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  8. Maria Alcoba
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  9. Eduardo Ruiz
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  10. Joaquim Sarquella
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Corresponding author

Correspondence to Marco Cosentino.

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All authors declare that there is no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Cosentino, M., Peraza, M.F., Vives, A. et al. Factors predicting success after microsurgical vasovasostomy. Int Urol Nephrol 50, 625–632 (2018). https://doi.org/10.1007/s11255-018-1810-4

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  • DOI: https://doi.org/10.1007/s11255-018-1810-4

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