Effectiveness and complications associated with 2 vasectomy occlusion techniques.
OBJECTIVE
We compared the effectiveness and complications associated with 2 common vasectomy occlusion techniques, namely clipping and excision of a small vas segment and thermal cautery with fascial interposition and an open testicular end.


METHODS
We retrospectively reviewed the computerized records of 3,761 men who underwent initial vasectomy at a single university hospital family planning clinic and at 2 private clinics in the Quebec City, Canada area, including concurrent and historical controls. All procedures were performed by 1 surgeon, who used the scalpel-free technique to expose the vas.


RESULTS
The risk of vas occlusion failure in men with at least 1 semen analysis was much greater in the clipping and excision group than in the cautery, interposition and open testicular end group (126 of 1,453 or 8.7% versus 3 of 1,165 or 0.3%, OR 37, 95% CI 12 to 116). Medical consultations for hematoma or infection were more frequent in the cautery group (28 of 1,721 cases or 1.6% versus 10 of 2,040 or 0.5%, OR 3.4, 95% CI 1.6 to 6.9). Consultations for noninfectious pain were similar for the 2 techniques (71 of 1,721 cases or 4.1% versus 72 of 2,040 or 3.5%, OR 1.2, 95% CI 0.8 to 1.6).


CONCLUSIONS
Cautery and interposition with an open testicular end are much more effective than clipping and excision. The effectiveness and morbidity associated with the components of the cautery, interposition and open testicular end technique need further evaluation.
Labrecque
Michel
M
Department of Family Medicine and the Research centres, Centre Hospitalier Affilié, and CHQU, Laval University, Quebec, Canada.
Nazerali
Hanif
H
Mondor
Myrto
M
Fortin
Vincent
V
Nasution
Marlina
M
D002425:Cautery; D006801:Humans; D008026:Ligation; D008297:Male; D012189:Retrospective Studies; D013076:Sperm Count; D013081:Sperm Motility; D013525:Surgical Instruments; D017211:Treatment Failure; D014649:Vas Deferens / Q000601:surgery; D014659:Vasectomy / Q000009:adverse effects / Q000379:methods*