Microsurgical vasectomy reversal: experience of a single center

Background: Vasectomy reversal (VR) is the only technique that allows men previously submitted to a vasectomy to conceive by natural pregnancy. We report our experience with microsurgical VR and identify predictive factors of natural pregnancy. Methods: We retrospectively reviewed all patients submitted to VR by a single surgeon from 2008 to 2021 at our single center. Patency and pregnancy rates were evaluated. The main outcomes after surgery were the patency and natural pregnancy rates. Secondary outcomes were the identification of predictive factors of success and patient satisfaction with the natural pregnancy. Results: Forty VRs were performed with a patency rate of 97.1% and, among those who became patent, pregnancy occurred in 13 of 31 couples by natural conception (41.9%). Two-layer anastomosis was significantly associated with a successful procedure (Odds Ratio of 12.428; p = 0.045). We did not identify a significant association between any of the other variables and a successful outcome. Even without a successful surgery, most of the patients were very satisfied with the results and would do the procedure again. Conclusions: VR is a useful technique for men previously submitted to a vasectomy and who pretend to have children by natural conception. Two- layer anastomosis is significantly associated with a successful surgery.