Vasectomy Reversal Surgical Patterns: an Analysis of the American Board of Urology Case Logs

• Published in: Urology (Ridgewood, N.J.) Vol. 107; pp. 107 - 113
• Main Authors: Nseyo, Unwanaobong, MD, MHS, Patel, Nishant, MD, Hsieh, Tung-Chin, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2017
• Subjects: Adult; Female; Humans; Male; Middle Aged; Practice Patterns, Physicians; Retrospective Studies; Specialty Boards - statistics & numerical data; Surveys and Questionnaires; United States; Urologists - standards; Urology; Vasectomy - methods; Vasectomy - standards; vasovasostomy; epididymovasostomy; male infertility; vasectomy reversal
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2016.08.066

Abstract Objective To characterize vasectomy reversal practice patterns among American Board of Urology (ABU) certifying urologists. Materials and Methods We reviewed the ABU case logs for certifying urologists from 2008 to 2014. Vasectomy reversal procedures were identified by three CPT codes: 55400 (vasovasostomy), 54900 (epididymovasostomy, unilateral), 54901 (epididymovasostomy, bilateral). Demographic data was obtained and reviewed. Multivariate analysis was determined factors influencing the performance of surgical approach. Results 5167 urologists submitted case logs for 2008-2014, 9.4 % (486) had performed at least one vasectomy reversal procedure. General urologists accounted for the highest overall volume of vasectomy reversal procedures. Andrology-trained urologists performed a higher volume of V-V per surgeon and bilateral E-V constituted a greater portion of their E-V practice. Multivariate analysis demonstrated that being in recertification years, younger surgeon age, practicing in the South Central, Southeast and Western regions, and practicing in the largest and smallest practice areas were associated with being more likely to perform a vasectomy reversal procedure. Conclusions Microsurgical vasectomy reversals are putatively considered technically challenging and reserved for fellowship-trained urologists, the majority of vasectomy reversal surgeries were performed by general urologists. Given the known association between microsurgical technique and improved outcomes, greater emphasis should be placed on microsurgical training during urology residency.