The results of vasectomy reversal are reported as two
percentages. The first is patency rate; the
percentage of men who have the return of sperm in the ejaculate
after reversal. This means that the operation was technically
successful. The second statistic reported is the pregnancy rate.
The pregnancy rate is always lower than the patency rate because
many more factors play a role in getting pregnant other that the
return of sperm in the ejaculate. The results of microsurgical
vasovasostomy from the Vasovasostomy Study Group data are >90%
patency if sperm were present in the vasal fluid at the time of
surgery and pregnancy rates up to 76%. This is the study quoted
by most surgeons when asked about results of vasectomy reversal.
There are too many variables to give honest meaningful numbers
for a comparison. Unfortunately statisticians can and do use
numbers to say what they want. Likewise, a guarantee of 1
million sperm still means you are sterile. This surgery is very
precise and results depend largely on the skill of the surgeon
and the health of the testicles.
However, smoking history, the age of the patient and spouse,
previous fertility history, and time since the vasectomy was
performed are all important variables.
For
microsurgical vasoepididymostomy the patency rate is over 60%
and the pregnancy rate is 40%. Data collected by the
Vasovasostomy Study Group (the largest multicenter study of
vasectomy reversals, published in 1991) showed a distinct
increase in success rates when the surgery was performed using
an operating microscope by a skilled micro surgeon as opposed to
utilizing loop magnification.
The North Carolina
Medical Board has issued a position statement with regard to
quoting surgical outcomes statistics as well which I have
copied below:
North Carolina Medical Board Position
Statement
ADVERTISING AND
PUBLICITY*
It is the position of the North Carolina
Medical Board that physician advertising or publicity that is
deceptive, false, or misleading is unprofessional conduct. The
key issue is whether advertising and publicity, regardless of
format or content, are true and not materially misleading.
Information
conveyed may include:
-
the basis on which fees are determined, including
charges for specific services;
-
methods of payment;
-
any other non-deceptive information.
Advertising and publicity that create unjustified medical
expectations, that are accompanied by deceptive claims, or that
imply exclusive or unique skills or remedies must be avoided.
Similarly, a statement that a physician has cured or
successfully treated a large number of patients suffering a
particular ailment is deceptive if it implies a certainty of
results and/or creates unjustified or misleading expectations.
If patient photographs are used, they should be of the
physician's own patients and demonstrate realistic outcomes.
Consistent with federal regulations that apply to commercial
advertising, a physician who is preparing or authorizing an
advertisement or publicity item should ensure in advance that
the communication is explicitly and implicitly truthful and not
misleading. Physicians should list their names under a specific
specialty in classified telephone directories and other
commercial directories only if they are board certified or have
successfully completed a training program in that specialty
accredited by the Accreditation Council for Graduate Medical
Education or approved by the Council on Postdoctoral Training of
the American Osteopathic Association.
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