Results of Vasovasostomy or Vasoepididymostomy After Failed Percutaneous Epididymal Sperm Aspirations

Marmar, Joel L.
Sharlip, Ira
Goldstein, Marc

^aRobert Wood Johnson Medical School at Camden, Camden, New Jersey
^bUniversity of California, San Francisco, California
^cWeill Medical College of Cornell University, New York, New York

^* Correspondence: Robert Wood Johnson Medical School at Camden, 3 Cooper Plaza-Suite 411, Camden, New Jersey 08103 (e-mail: [email protected]).

^† Financial interest and/or other relationship with Wellspring Urology.

^‡ Financial interest and/or other relationship with Bayer, GSK, Schering-Plough, Johnson & Johnson, Pfizer and Eli Lilly & Co.

Study received institutional review board approval.

See Editorial on page 1225.

Submitted for publication 4 June 2007.

Journal of Urology 179(4):p 1506-1509, April 2008.

Purpose

After undergoing vasectomy approximately 4% to 6% of men change their minds and desire more children. In the past they had 2 options: 1) vasectomy reversal and 2) sperm retrieval and intracytoplasmic sperm injection. However, in our practices we began to receive requests for another option: reconstructive microsurgery after failed percutaneous epididymal sperm aspiration.

Materials and Methods

In this report we combined our collective experience with 8 patients who requested reconstructive microsurgery after failed percutaneous epididymal sperm aspiration and intracytoplasmic sperm injection.

Results

Our intraoperative findings demonstrated minimal trauma to the epididymis resulting from percutaneous epididymal sperm aspiration. At surgery sperm were found in the testicular vas fluid in 10 of 16 vasal units, and vasovasostomy was possible on at least 1 side in 7 of 8 patients. Vasoepididymostomy was possible when needed. Of the 8 couples 4 achieved pregnancy (50%).

Conclusions

Vasovasostomy or vasoepididymostomy is possible after percutaneous epididymal sperm aspiration.