Patient Factors Influencing Decision to Undergo Vasectomy Reversal

Urol Pract. 2019 Jan;6(1):40-44. doi: 10.1016/j.urpr.2018.02.003. Epub 2018 Dec 27.

Abstract

Introduction: Vasectomy reversal is one of the options for having children following a vasectomy. While previous reports have shown this procedure to be cost-effective, barriers remain preventing some couples from using this method. We determined the factors that influence patients' decision to undergo vasectomy reversal and identified possible barriers.

Methods: A review was conducted of 398 patients who were seen for consultation regarding vasectomy reversal between January 2006 and January 2016. Patients were contacted via mail and asked to fill out an anonymous survey. Medical records of patients who returned surveys were reviewed and de-identified data accrued in our data set. Patient demographics, socioeconomic data, family composition and patient identified barriers to vasectomy reversal were characterized. Data were analyzed with standard comparative and descriptive statistical analysis.

Results: Overall 30.9% of patients responded to the survey and chart review was subsequently conducted. Demographics were similar for individuals who did and did not undergo vasectomy reversal. The most common reason for the initial consultation was the patient's and the partner's desire for children (74.0%). The most commonly identified barrier to vasectomy reversal was cost (53.7%), followed by concern about success rate (31.7%). Patients who underwent vasectomy reversal more often had an income greater than $100,000 per year compared to those who did not undergo vasectomy reversal (50.5% vs 21.9%, p=0.004). Individuals who did not undergo vasectomy reversal more often had a new partner since vasectomy (87.5% vs 70.3%, p=0.05) and were unmarried (28.1% vs 8.8%, p=0.02).

Conclusions: The most common reason for presentation for vasectomy reversal was a joint desire for children. The largest barrier to vasectomy reversal was cost. Individuals with lower incomes, a new partner and unmarried status were less likely to undergo vasectomy reversal.

Keywords: decision making; vasovasostomy.