Formula for a VE or VV Interesting Article

[carrie1013]

Update: I do not think this is the absolute truth, just and interesting study and it seems to me that testing the theory on only 50 men is way to small of a test group!

I posted this over on BBC in response to a gal who was wondering whether DH should have a VE or VV. I also was curious and started surfin to see what I could find. I found a medical journal and typed up a little synopsis--

There is an article in the Journal of Urology (2005) “Model To Predict If a Vasoepididymostomy Will Be Required For Vasectomy Reversal”
By Sijo J. Parekattil, Wayne Kuang, Ashok Agarwal and Anthony J. Thomas from the Glickman Urologic Institute, Cleveland, OH
Here is my synopsis:

These researchers looked at a group of 483 men and tried to devise a formula that would accurately identify men who would need the VE over the VV so that the patients would be sent to the appropriate doctor to better divide the patients among doctors and funnel the men mostly likely in need of a more experienced VE doctor.
The formula they used was (age x 0.31) + (years since V x 0.94)=score,
Any score less than 20 means the man will only need a VV, over 20 then it is likely a VE (one sided or both) will be required.

This formula was used on 50 men to determine the accuracy. Of the men who, by the formula, needed a VV the formula was 100% in predicting those men. Of the men, which the formula predicted would need a VE, either on one side or both, it was 58.8% accurate. This means that the other 41.2% of men thought to need a VE actually only ended up needing a VV.

The parameters that were used to determine if the VV or VE was needed was based upon the “gross and microscopic appearance of the vassal fluid from the proximal vas (testicular side). A [VE] was performed if the proximal vasal fluid had characteristics such as no fluid (after irrigation or milking of the vas), no sperm with thick, pasty fluid or few sperm parts with thick pasty or creamy fluid.”

In this study it was determined the following:
0-<3 years since V resulted in 0% of men needing the VE
3-8 years since V resulted in 2.6% needing the VE
9-14 years since V resulted in 26.3%
14 or more since V resulted in 43.2%

The 50 patient test group according to formula predicted 30 needing the VE, of these 30 only 16 needed one VE on either side and another 6 needed VE on both sides.

[lifesabeach]

I don't fully agree with this study simply because age of VR is not a true predictor of whether it is able to be reversed. It can be used as a guideline, but I don't think there is a hard and fast rule for it. Some other things that need to be considered are scarring, varioceles, how well the V was actually performed, presence or absence of sperm at the connection site, etc. None of these things can be known without scoping it out first.

Maybe I'm biased because it was wrong for us. DH's V was approximately 6 years old. He was extremely fertile before the V. He doesn't have a tendency to heal badly from things. Dr. W even said his "anatomy was perfect." Alas, here we are a year later with a failed VR. I think Dr. W did his job just fine. I just know that if we had done a VE, we'd have a different outcome. We could have a re-do, but DH doesn't want to travel far again, so Dr. Daniel is a 3 hour drive from us. He is also pricey, and we can't afford another $5800 right now.

[carrie1013]

You don't have to agree, I just thought it was interesting and I enjoy research and data and had not come across anything that really said one way or another. The formula proposal was based on 483 men who had had VR between the ages of 27 and 61, with anywhere from less than a year to over 14 year from V. It is hard to assess the validity of the sample size since it did not provide the average yearly number of VR performed.

The goal of the study was to be able to be able to provide the hospital or clinic the knowledge to place the right patient with the necessary skilled doctor. To make clinics more efficient and patient satisfaction.

Thank you for sharing you info and I am praying that you get your turn!

[hsmom24]

That's a very interesting theory for the formula, but we're living proof of it's inaccuracy. Based on that formula, my DH scores a 16.19, and he needed double VEs. I could see this formula being used to attempt to predict which procedure would be necessary, but each man is completely unique, and the way his body heals can NOT be predicted. And in the end, it's how his body A) healed from the V (and not just heals from the incisions, but handles the change in his body) that tells whether a VV or VE is needed, and B) will heal from the VR that tells whether the VR will even be successful. No formula on the world can give wholly accurate predictions with subjects that are so variable, and don't follow a strict pattern.

[carrie1013]

If there is any accuracy at all it sounds like you were the 2.6% I pray we aren't but, it will be what it will be.

[lifesabeach]

I hope it didn't come across that I was attacking you or anything for posting it, because I wasn't. I was just posting a response to the actual study. And it might be true, that Leslie's DH and my DH were just in that unlucky 2.8%. Except Leslie was lucky enough to have used Dr. Finnerty, who does the VE's.

I wonder if one day they'll have good enough ultrasound equipment to get a good picture of what's going on and be able to tell "yep, there's a blockage at XYZ point, we'll need to do a VE." That would be cool.

[carrie1013]

ohno!!! I did not feel attacked just did not want you all to think I was narrow-minded that I believe everything I read or whatever, just wanted to be clear that I thought it was an interesting idea. It appeals to my nutty need to be able to find an answer or reason for why? how? etc.
I was on BBC and someone was asking about "VV or VE?" and what she should go with kind of thing. Anyway, I realized I hadn't read anything specific to her question and went on a hunt. Came up with the article and was like--wow that is interesting! I am nerd and love the whole scientific process, and then when I see real stats based on real numbers I was just thrilled find this little treasure to read decipher and summarize!

I actually thought I might have offended you!

[kews]

I calculated DH for this and according to their study he would have needed a VE, but he ended up needing only VV