- One of the safest and most effective means of contraception
- Approximately 100,000 vasectomies are performed in United Kingdom
each year
- 1 in 6 men over the age of 35 years have had a vasectomy
- Most are performed under local anaesthetics
- Most surgeons excise a segment of the vas deferens
- Both ends of the vas are usually ligated
- Fascial interposition is more effective than ligation alone
- Recovery is rapid and complications are rare
- Postoperative semen samples are required at 8 and 12 weeks
- Need two negative specimens before other forms of contraception can
be abandoned
- Failure can occur and pregnancy has been reported following 1 in
2000 vasectomies
- 5% of men subsequently seek vasectomy reversal
Complications
- Bruising or haematoma
- Wound infection
- Epididymo-orchitis
- Sperm granuloma
- Chronic testicular pain
Reversal of vasectomy
- A vasectomy can be reversed by either
- Vasovasostomy
- Vasoepididymostomy
- In experienced hands vasovasostomy can result in:
- Tube patency rates of greater than 90%
- Pregnancy in more than 50%
- Outcome depends on several factors
- Time since surgery vasectomy is important
- More likely to be successful if performed with 3 years of vasectomy
- Greater success with microsurgical techniques
Bibliography
Aradhya K W, Best K, Sokal D C. Recent developments
in vasectomy. BMJ 2005; 330: 296-2999
Awsare N S, Krishnan J, Boustead G B et al.
Complications of vasectomy. Ann R Coll Surg Eng 2005;
86: 405-410.
Gingell C, Crosby D, Carroll R. Review of the
complications and medicolegal implications of vasectomy. Postgrad
Med J 2001; 77: 656-659.
Schroeder-Printzen I, Diemer T, Weidner W. Vasovasostomy.
Urol Int 2003; 70; 101-107 |