Araújo Dr. Débora C, Maciel Dr. Rui, Bastos Dr. Samuel, Oliveira Dr. Vitor, Dias Dr. Jorge, Marramaque Dr. Carolina, Gromicho Dr. Alexandre, Xambre Dr. Luis

(230) MICROSURGICAL VASECTOMY REVERSAL: THE EXPERIENCE OF THE SINGLE CENTER

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives We report our experience with microsurgical VR and identify predictive factors of success. Methods We retrospectively reviewed all patients submitted to VR by a single surgeon from 2008 to 2021 at Centro Hospitalar Vila Nova de Gaia e Espinho. Patency and pregnancy rates were evaluated. The main outcome was procedure success rate, defined by a natural pregnancy with a healthy baby. The secondary objective was to identify predictive factors of success and patient satisfaction with the procedure. Results Forty VRs were performed with a patency rate of 97.2%. Among those who became patent, pregnancy occurred in 14 of 35 couples by natural conception (40%). Twelve of them had a healthy delivery (34.3%). Two-layer anastomosis was significantly associated with a successful procedure (p=0.0001). We did not identify significant association between any of the other variables and successful outcome. Even without successful surgery most of the patients would do the procedure again and were very satisfied with the results (p=0.58 and p=0.46, respectively). Conclusions This is the largest national cohort regarding the outcomes of VR. In our study, the observed patency rate was 97.2%, resulting in a pregnancy by natural conception with a healthy delivery in 34.3%. We believe that VR is a useful technique to restore fertility in men after vasectomy wishing children by natural conception. A significant association was found between the two-layer anastomosis and a successful surgery. Conflicts of Interest The authors declare that they have followed the protocols of their work center on the publication of patient data.

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