Does Epididymal Induration Predict the Need for
Epididymovasostomy at Vasectomy Reversal?

Objectives

Very few clinical parameters correlate well with the need to perform epididymovasostomy (EV) during vasectomy reversal procedures. In addition to the time interval from vasectomy to reversal, the presence of a sperm granuloma is helpful in counseling patients in this regard. We assess whether the presence of dilated epididymides on physical examination can further inform surgeons on this issue.

Design

Case controlled retrospective analysis of a consecutive series of patients.

Materials and Methods

From the last 80 patients who underwent vasectomy reversal by a single surgeon, data on the presence or absence of epididymal induration was recorded on individual testicular units. Epididymal induration was defined as an enlarged or tense (but not necessarily tender) epididymis. This information was correlated with the type of reversal procedure performed and the intraoperative findings. EV’s were performed in the absence of sperm at the testicular vas deferens. Unpaired t tests were used for statistical comparisons.

Results

Findings are provided in the table in the downloadable PDF.

Conclusion

Epididymal induration on preoperative exam for vasectomy reversal surgery is associated with a longer obstructive interval after vasectomy. With this finding, the likelihood of EV surgery doubles. This information may supplement other data used in counseling these patients.

Need for Epididymovasostomy at Vasectomy Reversal