Vasovasostomy common in men undergoing vasectomy reversal after testosterone therapy

Among men seeking vasectomy reversal (VR) after testosterone therapy (TT), vasovasostomy (VV) appears to be a very common procedure that is likely to succeed.

The researchers conducted a retrospective case series of 14 men who had undergone prior vasectomy and subsequent TT and have opted for VR. At the time of reversal, men had a median age of 14 years and showed a median obstructive interval of 11 years.

Participants also received medical therapy (MT) to help recover spermatogenesis. The median time from MT to VR was 5 months.

In terms of the specific procedure applied, almost all patients (96 percent) received VV, while only one underwent end-to-side epididymovasostomy.

Of the 14 patients who underwent reversal, two had achieved pregnancy before semen analysis, so their semen samples were assumed to be patent, defined as the presence of sperm. Another patient was hypogonadal and semen analysis was deferred. In the 11 remaining patients, eight showed normal levels of sperm. The remaining patients either had oligospermia or sperm fragments on semen analysis.

Overall, five men were able to achieve pregnancy culminating in live births.

“Our findings support favourable outcomes with more liberal VV indications after medical therapy in patients previously on TT that desire VR,” the researchers said.

“The use of medical therapy reduced the recommended wait times for VR after TT discontinuation alone by more than half, and the high rate of VV and sustained patency despite an 11-year median obstructive interval indicates that VR in this population is very likely to succeed,” they added.