Vasectomy by epithelial curettage without suture or cautery: a pilot study in humans.
Curettage of the epithelium of the vas deferens might be a safe and effective method of male sterilization. We conducted a pilot study of vasectomy by epithelial curettage with a novel microcurette called the Vas-X in 12 normal men requesting elective sterilization. Seminal fluid analysis was obtained monthly after the procedure for 6 months. Pain was assessed by questionnaire. Three months after the procedure, all men attained sperm concentrations of less than 0.2 million sperm per mL, and seven were azoospermic. Post-procedural pain was minimal. Nine men ultimately achieved and maintained azoospermia; however, 4 to 6 months after the procedure, sperm concentrations increased in three of the 12 subjects, necessitating repeat vasectomy. Microscopic examination of the vas deferens from these failures revealed re-canalization. Vasectomy by epithelial curettage can result in effective sterilization; however, 1/4 of the subjects were not effectively sterilized by the procedure due to re-canalization of the vas deferens. Epithelial curettage will require further refinement to determine if it is a viable form of vasectomy.
Amory
John K
JK
Department of Medicine, Center for Research in Reproduction and Contraception, University of Washington School of Medicine, Seattle, WA 98195, USA. jamory@u.washington.edu
Jessen
John W
JW
Muller
Charles
C
Berger
Richard E
RE
D000328:Adult; D002425:Cautery; D003475:Curettage / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009845:Oligospermia / Q000209:etiology; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology; D010865:Pilot Projects; D012661:Semen / Q000166:cytology; D013094:Spermatozoa / Q000166:cytology; D013243:Sterilization Reversal; D013245:Sterilization, Reproductive / Q000379:methods*; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D013537:Sutures; D014649:Vas Deferens / Q000166:cytology / Q000601:surgery*; D014659:Vasectomy / Q000009:adverse effects / Q000379:methods*