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Urology (Expert Forum)
Vasectomy procedures
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Vasectomy procedures
by Holden-Markle, Jan 30, 1998 12:00AM
Re: Vasectomy procedures
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Posted by HFHS M.D.-MS on February 02, 1998 at 09:28:49:
In Reply to: Vasectomy procedures posted by Holden Markle on January 30, 1998 at 16:47:02:
: I am having a great deal of difficulty finding information relating to the benefits/side effects/hazzards of two different techniques. Specifically the relative mertits between the "open ended" (where the supply side of the vas deferens is left untied to drain freely into the scrotum) and the "closed ended" vasectomy technique (where both ends of the severed vas are tied and cauterized).
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Dear Holden:
Thank you for your question.
Both of us are probably having the same difficulty information on the open ended vasectomy you spoke of. In the literature, the length of vas deferens removed and the method of occlusion predict the recanalization ( failure) rate. At the Henry Ford Hospital the urologists occlude both ends of the vas with a tie or clip or cauterize the lumen (interior of the tube). It has been quoted that the cauterization of the vas lumen after occlusion results in less than a 0.5% failure rate. The placement of nearby tissue between these two ends also help reduce the failure rates. Some urologist do not perform the latter technique because it adds time and no well done studies have been performed to document the failure rates of any of these above mentioned techniques.
The open ended technique you spoke of have been described in the last 20 yrs by authors who have been interested in making vasectomy more reversible in case the patient changed his mind. The motive behind leaving the testes side of the vas open was to decrease the theoretical damaging effects to the sperm formation caused by “back pressure” which was generated by tying off the vas. (Silber 1977) . Initially the failure rates for the open end technique ranged from 7 to 50% now with improvement and in experienced hands the failure rate is around 4%. These techniques include separating the ends further thereby making for a more invasive procedure which probably has more complications.
Generally the main complication rates for vasectomy are: 2% hematoma(blood clot collection), infection 3.4%... The complication rate vary depending on how many vasectomies the doctor does a year.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
More individualized care is available at the Henry Ford Hospital and its satellites (1-800 653 6568).
Sincerely
HFHS-M.D. MS
*Keyword: vasectomy
