Department of Urology, Centre Hospitalier Universitaire, Université Catholique de Louvain, Namur, Belgium.
Department of Urology, University Clinics Brussels, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Andrology. 2022 Oct;10(7):1286-1291. doi: 10.1111/andr.13182.
Effective male contraceptive options are condoms and vasectomy. Vasectomy should not be considered a reversible method of contraception even if vasovasostomy can be offered to men to restore fertility after vasectomy. Therefore, there is a real questioning among urologists concerning cryopreservation before vasectomy. We carried out an international survey concerning the practice of cryopreservation before vasectomy and during vasovasostomy.
An online anonymous survey was submitted from January to June 2021 to six European urological societies. The 31-items questionnaire included questions about demography, habits of cryopreservation before vasectomy or during vasectomy reversal, and in case of urogenital cancers.
228 urologists from six urological societies in five different countries (Belgium, Netherlands, Luxembourg, France, Finland) answered the questionnaire. French urologists were more in favor of cryopreservation before vasectomy than other European urologists (p < 0.0001). They also significantly found that not talking about cryopreservation before vasectomy is a medical fault unlike other urologists (p < 0.0001). The specialization in andrology did not influence the choice of cryopreservation before vasectomy (p = 0.9452). The majority of urologists did not perform intraoperative sperm extraction during vasovasostomy (81%; n = 127) with a significant difference between urologists with or without andrology training (p = 0.0146). Success rates after vasovasostomy are significantly better for robot-assisted surgery (p = 0.0159) or with a microscope (p = 0.0456) versus without a microscope.
Cryopreservation before definitive sterilization significantly varies among European urologists and seems to be mostly dictated by habits than by knowledge. An international consensus is needed to standardize practices and guide patients' choices.
有效的男性避孕方法是避孕套和输精管切除术。输精管切除术不应被视为一种可逆的避孕方法，即使可以为男性提供输精管吻合术来恢复输精管切除术后的生育能力。因此，泌尿科医生对输精管切除术前的冷冻保存确实存在质疑。我们进行了一项关于输精管切除术前和输精管吻合术期间冷冻保存实践的国际调查。
从 2021 年 1 月至 6 月，向六个欧洲泌尿科协会提交了一项在线匿名调查。该 31 项问卷包括关于人口统计学、输精管切除术前或输精管吻合术期间冷冻保存习惯以及泌尿生殖系统癌症的问题。
来自五个不同国家（比利时、荷兰、卢森堡、法国、芬兰）的六个泌尿科协会的 228 名泌尿科医生回答了问卷。与其他欧洲泌尿科医生相比，法国泌尿科医生更倾向于在输精管切除术前进行冷冻保存（p<0.0001）。他们还发现，与其他泌尿科医生不同，不谈论输精管切除术前的冷冻保存是一种医疗失误（p<0.0001）。泌尿科医生的专业领域是否为男科并不影响其对输精管切除术前冷冻保存的选择（p=0.9452）。大多数泌尿科医生在输精管吻合术中不进行术中精子提取（81%；n=127），具有男科培训和无男科培训的泌尿科医生之间存在显著差异（p=0.0146）。机器人辅助手术（p=0.0159）或显微镜下手术（p=0.0456）的输精管吻合术成功率明显高于无显微镜下手术。
欧洲泌尿科医生之间输精管切除术前的冷冻保存差异显著，这似乎主要取决于习惯，而不是知识。需要国际共识来规范实践并指导患者的选择。
