title: Current practice in the management of vasectomy reversal and unobstructive azoospermia in Merseyside & North Wales: a questionnaire-based survey.
abstract: OBJECTIVE
  To investigate the current incidence of vasectomy reversal procedures, the techniques used and which practitioners use them.
  
  
  METHODS
  Using a questionnaire, 130 general surgeons and urologists practising in Merseyside and North Wales were surveyed.
  
  
  RESULTS
  The response rate was 74%, with 24 urological surgeons and 14 general surgeons undertaking vasectomy reversal. Annually, urological surgeons carried out significantly more procedures than did general surgeons, at 8.5 and 5.3 (P = 0.029), respectively. They were also more likely to use double-layer closure and microsurgical techniques, whilst significantly less likely to use stents. Urologists reported significantly greater patency rates, at 76% and 52% (P = 0.017), respectively, with no significant differences in subsequent pregnancy rates (30% vs 25%). Only one practitioner checked tubal patency in the female partner before vasectomy reversal.
  
  
  CONCLUSIONS
  The use of vasectomy reversal is a cost-effective treatment for men wanting paternity after vasectomy. The technique used by the clinician and proper audit of the results require close attention; it would also appear to be obvious that all the partners of men seeking a vasectomy reversal should have their fertility status established before reversal, something that is clearly not done at present.
authors.affiliation: Reproductive Medicine Unit, Liverpool Women's Hospital, UK. simon_j.wood@virgin.net
authors.forename: S
authors.initials: S
authors.lastname: Wood
authors.forename: N
authors.initials: N
authors.lastname: Montazeri
authors.forename: Y
authors.initials: Y
authors.lastname: Sajjad
authors.forename: S
authors.initials: S
authors.lastname: Troup
authors.forename: C R
authors.initials: CR
authors.lastname: Kingsland
authors.forename: D I
authors.initials: DI
authors.lastname: Lewis-Jones
mesh_terms: D001291:Attitude of Health Personnel; D015925:Cryopreservation / Q000706:statistics & numerical data; D004739:England; D019538:Health Care Surveys; D006306:Health Surveys; D006801:Humans; D008297:Male; D008485:Medical Audit; D009845:Oligospermia; D010818:Practice Patterns, Physicians'; D015607:Stents / Q000191:economics / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014669:Vasovasostomy / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D014852:Wales