Efficacy of percutaneous vas occlusion compared with conventional vasectomy.
OBJECTIVE
To determine the efficacy, evaluate the safety and assess side-effects (swelling, haematoma and pain) of percutaneous vas occlusion compared with vasectomy in Dutch men.


METHODS
Vas occlusion and vasectomy procedures (attempted in 58 and 50 men, respectively) were conducted at the University Hospital Maastricht. The men returned 1 week after the procedure, underwent a clinical examination and completed a questionnaire assessing subjectively any pain, swelling and haematoma. The men were asked to return for semen analysis at 6 and 12 weeks and, if necessary, for additional analyses until they were azoospermic.


RESULTS
The vas occlusion procedure was completed on both vasa in 49 of the 58 men (84%) in whom it was attempted. Significantly more (P < 0.001) men were azoospermic after vasectomy (48 of 50) than after vas occlusion (only four). Men undergoing vas occlusion reported significantly less pain (P = 0.02), swelling (P = 0.01) and haematoma (P = 0.04) after the procedure than did men undergoing vasectomy.


CONCLUSIONS
Men undergoing vas occlusion would not have been able to rely on the method for contraception. From this study, vas occlusion, at least in its current form, is an unsuitable method of male contraception. Not only was the efficacy poor, but constraints in delivering the method in its current state would probably limit its utility, especially in situations where resources are limited.
Zambon
J V
JV
Department of Urology, University Hospital Maastricht, Maastricht, The Netherlands. jza@suro.azm.nl
Barone
M A
MA
Pollack
A E
AE
Mehta
M
M
D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008026:Ligation / Q000009:adverse effects / Q000379:methods; D008297:Male; D012661:Semen / Q000737:chemistry; D012828:Silicones / Q000008:administration & dosage*; D016896:Treatment Outcome; D014649:Vas Deferens; D014659:Vasectomy / Q000379:methods*
D012828:Silicones