Vasectomy: A simple snip?
Vasectomy is one of the most common forms of permanent sterilization methods currently in use and has a failure rate of <1% in most reported series. Since failure of vasectomy may result in pregnancy, adequate counseling is essential. Couples are advised that an analysis of a semen specimen after vasectomy is required to confirm success before the use of alternative contraception is abandoned. However, measuring the success of vasectomy is complicated by a lack of consistency with regards to both the number and timing of tests and the end points accepted.


METHODS
A Medline search was used to identify manuscripts dealing with vasectomy, with specific attempts to identify protocols designed to confirm sterility.


CONCLUSIONS
Vasectomy is one of the most reliable permanent methods of contraception. However, despite its popularity, certain issues pertaining to the procedure remain unresolved. Debate continues over the relative merits of the various techniques of isolating and sealing the vasal ends. Postoperative complication rates remain minimal regardless of the technique used, and no single strategy attempting to maximize patient compliance with postoperative semen analysis has enjoyed unmitigated success. Long-term consequences, other than regret, are rare.
Dhar
Nivedita Bhatta
NB
Glickman Urological Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Jones
J Stephen
JS
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