Surgical developments take center stage in andrology

Key Points

There will always be a place for laboratory research in andrology, but the past year has been one of surgical advancements for those who diagnose and treat male infertility.

"There are certain things that always seem to be part of the conversation on the latest and greatest in andrology, but this year it seems that surgical developments are taking center stage," said Dr. Niederberger.

A team of Canadian researchers is set to report the results of a large series of men suggesting that favorable semen parameters, patency, and pregnancy rates can be realized in men whose vasectomies occurred more than 10 years earlier-provided the surgeon is proficient in both vasovasostomy and epididymovasostomy.

Speaking of technique, an American group will report surgical outcomes showing that while the probability of needing an epididymovasostomy (unilateral or bilateral) increases with vasectomy age, it does not go up indefinitely. After 2 decades or so, the need for bilateral vasovasostomy makes a resurgence.

"The moral of the story is that old expectations about the chances of a successful vasectomy reversal decreasing over time aren't necessarily true," Dr. Niederberger said. "After a certain point, they may actually start to get better.