Faculty Collaboration Database

Prednisone after vasectomy reversal may improve semen parameters: one institution's experience. Can J Urol 2020 Apr;27(2):10181-10184

Date

04/26/2020

Pubmed ID

32333738

Scopus ID

2-s2.0-85084030873 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

INTRODUCTION: Patients with suboptimal semen parameters following vasectomy reversal represent a diagnostic and therapeutic challenge. This may be caused by either partial or complete anastomotic obstruction. Despite the relatively common clinical use of corticosteroids in this patient population, data remain sparse. Thus, we set out to evaluate the safety and efficacy of prednisone after vasectomy reversal.

MATERIALS AND METHODS: A chart review was performed from January 1, 2008 to September 30, 2018 to identify men in which prednisone was used for suspected anastomotic obstruction after vasectomy reversal. Obstruction was based on sub-optimal or decreasing semen parameters and physical exam findings. A course consisted of 2 weeks of 20 mg PO daily followed by 2 weeks of 10 mg PO daily.

RESULTS: A total of 89 patients were identified in which prednisone was used postoperatively. Total motile sperm counts were found to increase in the overall cohort by 10.5 million (p < 0.0002) after a course of prednisone. On sub-group analysis, men who had a bilateral vasovasostomy (VV) or VV/vasoepididymostomy experienced an increase in total motile sperm counts by 13.4 million (p < 0.0012) and 6.2 million (p < 0.014), respectively. Patients who were patent at the time of prednisone treatment were more likely to see an improvement in total motile sperm counts (76.9% versus 33.3%, p < 0.003).

CONCLUSIONS: Prednisone seems to be safe and potentially efficacious in men with suspected anastomotic obstruction following vasectomy reversals. Further studies are needed to more conclusively determine the treatment's effectiveness in this patient cohort.

Author List

Machen GL, Doolittle J, Sandlow JI

Author

Jay I. Sandlow MD Chair, Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Glucocorticoids
Humans
Male
Middle Aged
Postoperative Period
Prednisone
Retrospective Studies
Sperm Count
Sperm Motility
Treatment Outcome
Vasovasostomy