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Validation of a vasoepididymostomy predictor model: is vasoepididymostomy truly predictable preoperatively?

  • Parviz K. Kavoussi
    Correspondence
    Reprint requests: Parviz Kavoussi, M.D., Division of Urology 3A, Scott and White Hospital, 2401 South 31st Street, Temple, Texas 76508 (FAX: 254-724-0218).
    Affiliations
    Department of Surgery, Division of Urology, Scott and White Memorial Hospital, Scott, Sherwood and Brindley Foundation, and the Texas A&M University System Health Science Center College of Medicine, Temple, Texas
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  • Erin T. Bird
    Affiliations
    Department of Surgery, Division of Urology, Scott and White Memorial Hospital, Scott, Sherwood and Brindley Foundation, and the Texas A&M University System Health Science Center College of Medicine, Temple, Texas
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      Objective

      To validate a vasoepididymostomy (VE) predictor nomogram.

      Design

      Data were collected prospectively. A previously published VE predictor model was then applied to all patients. Predicted outcomes were analyzed with respect to outcomes with consideration of actual procedures performed. The maximum follow-up was 30 months, with a median follow-up of 16 months.

      Setting

      A tertiary referral center in central Texas.

      Patient(s)

      One hundred fifteen consecutive patients who underwent vasectomy reversals by the fibrin glue technique were included.

      Result(s)

      Forty patients who would have been predicted to require VE on one or both sides by the predictor model actually underwent vasovasostomy (VV) bilaterally. Follow-up data were available in 62% of these patients, of which 88% were patent and 52% have achieved pregnancies thus far. Seventy patients who would have been predicted to only require VV by the predictor model underwent VV. Follow-up data were available in 60% of these patients, of which 98% were patent and 36% have achieved pregnancies thus far. The five patients not accounted for included two who would have been predicted to require VV and underwent VE because of intraoperative decision making and three who were predicted to require VE and underwent VE.

      Conclusion(s)

      The predictor model designed to identify which patients need VE versus those who will need simply VV is not a reliable predictor in our patient population of patients seeking a fibrin glue vasectomy reversal.

      Key Words

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