Presence of sperm in the pre-vasectomy reversal semen analysis: Incidence and implications

Purpose: We determined the incidence of sperm in the ejaculate before vasectomy reversal, and correlated this result with intraoperative and postoperative findings. Materials and Methods: Before vasectomy reversal semen was analyzed and granulomas were palpated in 186 men. The results were correlated with intraoperative vasal fluid and postoperative semen analyses. Results: Of 18 men (9.7%) with sperm present in the pre-reversal analysis 94% had sperm in at least 1 vas intraoperatively. The presence of palpable granulomas at the vasectomy site did not correlate with either pre-reversal or post-reversal semen analyses, or the presence of sperm in the vasal fluid intraoperatively. Conclusions: Sperm are present in 9.7% of pre-reversal ejaculates and predict sperm in at least 1 vas intraoperatively. These findings also suggest the possibility of late vasectomy failures.