Fulguration of the lumen does not improve vasectomy sterilization rates.
OBJECTIVE
To assess the effect of adding lumen diathermy fulguration to our standard technique of vas ligation with polyglactin 910 (Vicryl(TM), Ethicon, Sommerville, NJ, USA) excision and fascial interposition, in an attempt to improve our sterilization rates. We previously reported the effect of changing suture material on vasectomy success rates; 3005 post-vasectomy semen analyses (PVSA) revealed a decrease in sterilization rates after surgery on changing from chromic catgut to polyglactin 910.


METHODS
We retrospectively reviewed PVSA undertaken for vasectomies performed by urological surgeons at the Mid-Yorkshire NHS Trust for 18 months from September 2005 to February 2007.


RESULTS
There were 592 vasectomies in all; the age distribution of patients between the groups treated with the standard and new method was similar. Overall, 166 patients (28%) failed to provide two semen samples as instructed, and so were excluded from further analyses. Sterility was achieved in 367 patients (86%); a further 28 (7%) have indeterminate analyses to date, with one of the last two PVSAs showing sperm, with the PVSA of 32 (7%) patients showing persisting sperm. For the eight surgeons reviewed the sterility rates were broadly similar.


CONCLUSIONS
The introduction of diathermy fulguration of the lumen has not improved vasectomy sterilization rates, with up to 14% having sperm on PVSA.
Munro
Nicholas P
NP
Mid Yorks NHS Trust, Pinderfields General Hospital, Wakefield, Leeds, UK. nic@munron.plus.com
Kotwal
Sanjeev
S
Gogoi
Ng K
NK
Weston
Philip M T
PM
Browning
Anthony J
AJ
Harrison
Simon C W
SC
Biyani
Shekhar
S
Chahal
Rohit
R
Sundaram
Subramanian K
SK
D000328:Adult; D004564:Electrocoagulation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013076:Sperm Count / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014659:Vasectomy / Q000379:methods* / Q000706:statistics & numerical data