(090) DELAYED STENOSIS RATE POST VASECTOMY REVERSAL: A MULTICENTER COHORT

Abstract Introduction Outcomes with vasectomy reversal procedures for infertility have varied widely in the literature, with limited data available on long-term results. The current study objective was to provide data on long-term outcomes, including delayed stenosis rates using a multicenter dataset. Objective To evaluate the rate of long-term stenosis of men undergoing vasectomy reversal. Methods A retrospective study was performed of men undergoing vasectomy reversal for infertility by 14 surgeons from nine institutions. Each of the participating institutions had fellowship-trained andrologists specializing in male infertility and provided the data in an anonymous manner to optimize accuracy of reporting. Two institutions provided only limited datasets. The primary objective of the study was to evaluate the rate of long-term patency. Secondary objectives were to describe sperm concentration at various time points and by surgical team. For clinical variability, clinics without at least 10 data points were excluded from those analyses. Results A combined total of 3589 cases were included in the cohort, with 2838 having at least one test and 893 with at least one semen analysis available beyond 10 months. The percentage of patients with test results >10 months after surgery by clinic ranged from 1.2 to 47.5%, indicating wide discrepancies in follow-up protocols. Overall median sperm concentrations at <2, 2-4, 4-7, 7-10, 10-13, 13-18, and 18-24+ months were 5.8, 6.7, 5.3, 2.5, 1.3, 0, 1.2 million/ml, respectively. All-comer patency (defined as sperm at any point) rates ranged from 60-97%, with median maximal sperm concentration by clinic (any time point) ranging from 2-21 million/ml. Among men with at least two semen analyses, at least one of which was >10 months, 33.4% who initially had sperm went on to experience azoospermia (clinics varying from 2-48%). Overall patency rates at >10 months were 54% for the full cohort (range by clinic 41-93%). When reviewing data by surgeon, statistically significant differences were noted with all variables assessed, including the ratio of VV vs EV, successful completion rates of both sides, sperm concentrations, and short and long-term rates of azoospermia, suggesting notable differences in results based on surgical technique. Conclusions Using data from a combined cohort of 14 surgeons, approximately 54% of men who undergo vasectomy reversal for infertility experience durable patency at 10+ months with results varying significantly by surgeon. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: PathRight Medical.