{"doi":"10.1111/andr.12139","title":"Pre‐operative risk factors associated with need for vasoepididymostomy at the time of vasectomy reversal","abstract":"<jats:title>Summary</jats:title><jats:p>The absence of sperm in the ejaculate after vasectomy reversal is commonly caused by failure to recognize and subsequently bypass epididymal or proximal vasal obstruction at the time of vasectomy reversal. If intra‐operative proximal obstruction is suspected, vasoepididymostomy (<jats:styled-content style=\"fixed-case\">VE</jats:styled-content>) is recommended rather than vasovasostomy (<jats:styled-content style=\"fixed-case\">VV</jats:styled-content>). We sought to calculate the associated risk of needing <jats:styled-content style=\"fixed-case\">VE</jats:styled-content>, rather than <jats:styled-content style=\"fixed-case\">VV</jats:styled-content> with time from original vasectomy (obstructive interval) using a large cohort of vasectomy reversal patients. We reviewed the electronic and paper vasectomy reversal database by a single surgeon from 1978 through 2012. We performed univariate analysis to identify variables that predicted the need for <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> rather than <jats:styled-content style=\"fixed-case\">VV</jats:styled-content>, and then combined only significant univariates into our multi‐variable analysis. 2697 total men underwent vasectomy reversal, and 239 were repeat procedures. Of the 5296 individual testes operated on, 1029 were <jats:styled-content style=\"fixed-case\">VE</jats:styled-content>. Significant variables that predicted the need for <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> on univariate analysis included: age, obstructive time interval, vasectomy reversal after previous <jats:styled-content style=\"fixed-case\">VV</jats:styled-content> (repeat vasectomy reversal), and year the procedure was performed. On multi‐variable analysis significant risk factors for <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> were age above 50 (<jats:styled-content style=\"fixed-case\">OR</jats:styled-content> 1.36), repeat vasectomy reversal (<jats:styled-content style=\"fixed-case\">OR</jats:styled-content> 5.78), and greater obstructive time interval (<jats:styled-content style=\"fixed-case\">OR</jats:styled-content> 1.56). For every 3 years since original vasectomy, the risk of needing <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> increases by 56%. There is a linear relationship between obstructive interval and need for <jats:styled-content style=\"fixed-case\">VE</jats:styled-content>. Men undergoing repeat vasectomy reversal have five times greater risk of requiring <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> and men greater than 50 years of age are also at higher risk. Using these pre‐operative predictors is helpful in identifying patients who will benefit from referral to an experienced surgeon who can perform <jats:styled-content style=\"fixed-case\">VE</jats:styled-content>.</jats:p>","journal":"Andrology","year":2016,"id":658099,"datarank":0.6783182301660894,"base_score":2.639057329615259,"endowment":2.639057329615259,"self_citation_contribution":0.3958585994422889,"citation_network_contribution":0.2824596307238005,"self_endowment_contribution":0.3958585994422889,"citer_contribution":0.2824596307238005,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":12,"citers_with_citation_signal":8,"citers_with_endowment":8,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1717923,"name":"R. E. Anderson","orcid":null,"position":1,"is_corresponding":false},{"id":1717924,"name":"K. A. Ostrowski","orcid":null,"position":2,"is_corresponding":false},{"id":1717925,"name":"W. O. Brant","orcid":null,"position":3,"is_corresponding":false},{"id":1717926,"name":"E. F. Fuchs","orcid":null,"position":4,"is_corresponding":false},{"id":1717922,"name":"M. E. Fuchs","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Pre‐operative risk factors associated with need for vasoepididymostomy at the time of vasectomy reversal","abstract":"<jats:title>Summary</jats:title><jats:p>The absence of sperm in the ejaculate after vasectomy reversal is commonly caused by failure to recognize and subsequently bypass epididymal or proximal vasal obstruction at the time of vasectomy reversal. If intra‐operative proximal obstruction is suspected, vasoepididymostomy (<jats:styled-content style=\"fixed-case\">VE</jats:styled-content>) is recommended rather than vasovasostomy (<jats:styled-content style=\"fixed-case\">VV</jats:styled-content>). We sought to calculate the associated risk of needing <jats:styled-content style=\"fixed-case\">VE</jats:styled-content>, rather than <jats:styled-content style=\"fixed-case\">VV</jats:styled-content> with time from original vasectomy (obstructive interval) using a large cohort of vasectomy reversal patients. We reviewed the electronic and paper vasectomy reversal database by a single surgeon from 1978 through 2012. We performed univariate analysis to identify variables that predicted the need for <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> rather than <jats:styled-content style=\"fixed-case\">VV</jats:styled-content>, and then combined only significant univariates into our multi‐variable analysis. 2697 total men underwent vasectomy reversal, and 239 were repeat procedures. Of the 5296 individual testes operated on, 1029 were <jats:styled-content style=\"fixed-case\">VE</jats:styled-content>. Significant variables that predicted the need for <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> on univariate analysis included: age, obstructive time interval, vasectomy reversal after previous <jats:styled-content style=\"fixed-case\">VV</jats:styled-content> (repeat vasectomy reversal), and year the procedure was performed. On multi‐variable analysis significant risk factors for <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> were age above 50 (<jats:styled-content style=\"fixed-case\">OR</jats:styled-content> 1.36), repeat vasectomy reversal (<jats:styled-content style=\"fixed-case\">OR</jats:styled-content> 5.78), and greater obstructive time interval (<jats:styled-content style=\"fixed-case\">OR</jats:styled-content> 1.56). For every 3 years since original vasectomy, the risk of needing <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> increases by 56%. There is a linear relationship between obstructive interval and need for <jats:styled-content style=\"fixed-case\">VE</jats:styled-content>. Men undergoing repeat vasectomy reversal have five times greater risk of requiring <jats:styled-content style=\"fixed-case\">VE</jats:styled-content> and men greater than 50 years of age are also at higher risk. Using these pre‐operative predictors is helpful in identifying patients who will benefit from referral to an experienced surgeon who can perform <jats:styled-content style=\"fixed-case\">VE</jats:styled-content>.</jats:p>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"26663812","pmcid":null,"openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"bronze","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/andr.12139","host_type":"publisher"},{"url":"https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fandr.12139","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/andr.12139","host_type":"publisher"}],"fields_of_study":[],"mesh_terms":["Epididymis","Vas Deferens","Humans","Vasovasostomy","Risk Factors","Age Factors","Time Factors","Male","Azoospermia"],"keywords":["Infertility","Vasectomy","Surgical Intervention"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-12T03:17:44.997941Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}