Sperm Granuloma and Reversibility of Vasectomy.
Sperm Granuloma and Reversibility of Vasectomy.
Ninety-two consecutive patients who had undergone bilateral vasectomy 1 month to 28 years earlier were studied at the time of vasectomy reversal for sperm output, dilatation of the vas-deferens lumen, and sperm granuloma. Thirty-nine men had unilateral or bilateral sperm granuloma. The presence of of a sperm granuloma virtually assured normal sperm in the vas fluid no matter how long ago the vasectomy was performed. In the absence of a sperm granuloma, the interval since vasectomy had an important influence on the quality of vas fluid. The presence of a sperm granuloma was associated with significantly less dilatation of vas-deferens lumen at the testicular end. The site of the vasectomy and the amount of vas deferens removed did not influence sperm quality. A sperm granuloma on only one side resulted in normal spermatozoa in the vas fluid on that side, whereas the side without the sperm granuloma had abnormal spermatozoa or no spermatozoa in the vas fluid. It is concluded that when sperm granuloma follows vasectomy it vents the high pressure otherwise created by vasectomy and prevents disruption of sperm output in the vas fluid.
Source: Silber SJ.: Lancet. 1977 Sep 17;2(8038):588-9. Links
What is the Success Rate…
Nationwide vasectomy reversal success statistics are readily available. The most commonly cited article is the report of the Vasovasostomy Study Group which appeared in the Journal of Urology in March, 1991 (J Urol 145:505-511, March,1991; you can review or copy the article at your local hospital medical library). The single most important parameter determining success is the number of years since vasectomy. Within the first 3 years after vasectomy, reversal results in sperm recovery in over 97% of cases. From 3 to 8 years, about 91%; from 9 to 14 years, about 82%; and beyond 14 years, about 69%. Pregnancy rates (without fertility assistance) also drop slowly with time (from about 80% in the 3-year group to 35% in the >15-years group).
How Much Down Time to Expect
Patients must use greater caution following vasectomy reversal than following vasectomy, even more so following VE vs. VV . Depending on the surgeon’s protocol, patients may return to work 4-21 days following the procedure.
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