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Int Urol Nephrol (2014) 46:531537 DOI 10.1007/s11255-013-0517-9
UROLOGY - ORIGINAL PAPER
A comparison of epididymectomy with vasectomy reversal for the surgical treatment of postvasectomy pain syndrome
Joo Yong Lee Kang Su Cho Seung Hwan Lee Hee Ju Cho
Jeong Man Cho Cheol Young Oh June Hyun Han
Ki Soo Lee Tae Hyo Kim Seung Wook Lee
Received: 25 April 2013 / Accepted: 13 July 2013 / Published online: 21 September 2013 Springer Science+Business Media Dordrecht 2013
AbstractPurpose To compare the outcome of epididymectomy and vasectomy reversal (VR) in patients with postvasectomy pain syndrome (PVPS) who required surgical treatment.
Methods A total of 50 patients with PVPS who underwent epididymectomy or VR between January 2000 and January 2010 were included retrospectively. Of these, 36(72.0 %) patients completed the study questionnaire. These 36 patients completed the questionnaire either during attendance at the outpatient clinic or during a telephone interview. Twenty patients (22 cases) underwent epididymectomy, and sixteen patients (17 cases) underwent VR. Analyses were performed for (1) preoperative clinical ndings, (2) preoperative and postoperative visual analogue pain scale (VAPS) scores, (3) patency and pregnancy
rate in VR group, and (4) patient satisfaction with surgical treatment.
Results The mean age was 48.28 11.27 years, and the mean period of follow-up was 3.58 years (0.1510.03). The mean VAPS score was 6.78 0.93 preoperatively and1.13 0.72 postoperatively (p \ 0.001). The difference in the mean preoperative and postoperative VAPS scores was6.00 1.34 (38) in the epididymectomy group and5.50 1.03 (48) in the VR group. However, this difference was not statistically signicant (p = 0.227). No signicant difference in satisfaction with surgical outcome was observed between the epididymectomy and the VR groups (p = 0.124).
Conclusions In PVPS patients requiring surgical treatment, no signicant difference was observed between the epididymectomy and VR groups in either the reduction in pain or the degree of patient satisfaction with surgical outcome. Selection of the optimal surgical procedure may be dependent on specic patient characteristics.
Keywords Vasectomy Pain Epididymis
Vasovasostomy Treatment outcome
Introduction
Vasectomy is an effective method of male contraception and can be performed with relative ease. Approximately 4060 million men are reported to have undergone vasectomies worldwide, accounting for 510 % of all currently used methods of contraception [1]. An increase in the...