The need for further reproductive medical advice after vasectomy reversal.

The aim of this study was to determine the motivation of patients (n = 73) who had undergone microsurgical refertilization for further treatment (assisted reproduction) and the demand for medical counseling. By an interview, 57/73 patients could be evaluated for motivation, further demand for medical counseling, and the postoperative outcome (patency rate). In all, 60% of the patients who failed the treatment and 33% with a patent anastomosis mentioned interest for further counseling, especially for assisted reproduction. The satisfaction rate after the refertilization was nearly identical in the two groups (67%/64%). Following microscopical vasovasostomies the patency was 92%, which was significantly different from that observed after macroscopical refertilization (55%). In conclusion, the standard for refertilization is the microsurgical technique. Furthermore, there is a strong need for counseling that involves urological-andrological advice given by the same work group, including advisement on the techniques of assisted reproduction that might be necessary following the operative treatment.