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Abstract

Volume 25, Issue 3 (May 2023) 25, 416–420; 10.4103/aja202244

Vasectomy reversal in China during the recent decade: insights from a multicenter retrospective investigation

Li-Juan Ren, Rui-Zhi Xue, Zi-Qiang Wu, Er-Lei Zhi, Wei Li, Liang Huang, Xu-Yu Xiang, Dao-Yuan Li, Xue-Ming Lin

1 Department of Urology, First Hospital of Shanxi Medical University, Taiyuan 030000, China
2 Department of Urology, Xiangya Hospital of Central South University, Changsha 410000, China
3 Department of Urology, Shanghai General Hospital, Shanghai 200000, China
4 Department of Urology, Second Hospital of Tianjin Medical University, Tianjin 300000, China
5 Department of Urology, Zhujiang Hospital of Southern Medical University, Guangzhou 510000, China
6 Department of Urology, First Affiliated Hospital of Nanchang University, Nanchang 330000, China
7 Department of Urology, Hainan General Hospital, Haikou 570100, China

Correspondence: Dr. XM Lin (linxueming1985@126.com)

26-Jul-2022

Abstract

To date, there is little information about the demography of vasectomy reversal (VR) patients or the factors currently influencing VR effectiveness in China, especially after the universal two-child policy was released in 2015. In this research, demographic data and perioperative medical records of VR patients were extracted from seven major hospitals in different provinces or municipalities of China. Meanwhile, a telephone survey of the patients was conducted to collect follow-up information. Eventually, 448 VR cases from the past 13 years were included. The results were analyzed by stratified comparison to investigate factors that can influence postoperative vas deferens patency and pregnancy rate. Appropriately statistical methods were used, and all of the protocols were approved by the Ethics Committees of the institutes in this research. The results showed that the annual operation volume of VR quadrupled after the two-child policy was implemented. Nonmicrosurgery and a long duration of vasectomy were significantly associated with a lower patency rate. A follow-up survey showed that the general postoperative pregnancy rate was 27.2%. For female partners over the age of 35 years, the postoperative pregnancy rate showed a more severe decline, but only 35.5% of them had been given a fertility examination before their husbands' VR surgery. Our work revealed that more patients in China have been demanding VR in recent years. High-quality microsurgery and a short duration of vasectomy are crucial for restoring patency by VR. Clinical andrologists should perform a preoperative fertility evaluation of the patients' female partners.

Keywords: demography; microsurgery; multicenter; vasectomy reversal

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.