Current practice in the management of vasectomy reversal and unobstructive azoospermia in Merseyside & North Wales: a questionnaire‐based survey

• Published in: BJU international 2003-06, Vol.91 (9), p.839-844
• Main Authors: Wood, S., Montazeri, N., Sajjad, Y., Troup, S., Kingsland, C.R., Lewis‐Jones, D.I.
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Cryopreservation - statistics & numerical data; England; Health Care Surveys; Health Surveys; Humans; Male; Medical Audit; Oligospermia; Practice Patterns, Physicians; screening; Stents - economics; Stents - statistics & numerical data; survey; Surveys and Questionnaires; technique; vasectomy reversal; Vasovasostomy - economics; Vasovasostomy - methods; Vasovasostomy - statistics & numerical data; Wales
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1046/j.1464-410X.2003.04227.x

OBJECTIVE To investigate the current incidence of vasectomy reversal procedures, the techniques used and which practitioners use them. PATIENTS AND METHODS Using a questionnaire, 130 general surgeons and urologists practising in Merseyside and North Wales were surveyed. RESULTS The response rate was 74%, with 24 urological surgeons and 14 general surgeons undertaking vasectomy reversal. Annually, urological surgeons carried out significantly more procedures than did general surgeons, at 8.5 and 5.3 (P = 0.029), respectively. They were also more likely to use double‐layer closure and microsurgical techniques, whilst significantly less likely to use stents. Urologists reported significantly greater patency rates, at 76% and 52% (P = 0.017), respectively, with no significant differences in subsequent pregnancy rates (30% vs 25%). Only one practitioner checked tubal patency in the female partner before vasectomy reversal. CONCLUSIONS The use of vasectomy reversal is a cost‐effective treatment for men wanting paternity after vasectomy. The technique used by the clinician and proper audit of the results require close attention; it would also appear to be obvious that all the partners of men seeking a vasectomy reversal should have their fertility status established before reversal, something that is clearly not done at present.