Irrigation of the Distal Defferens during Vasectomy; Does it Accelerate the Post Vasectomy Sperm-Free Rate?
Apirak Lertsuwannaroj, Somboon Leungwattanakit, Krisada Ratana-Olarn
Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Bangkok 10400
Vasectomy is among the saftest and most reliable method of contraception but the disadvantage of the vasectomy is delayed sterility. In Thailand as elsewhere, they has been difficulty in making a vasectomized man realize that he is azoospermia until at least 10 weeks postoperatively. It is that important to counsel him about the inevitable post-vasectomy azoospermia. We compared two groups of men undergoing vasectomy ; NSS irrigation of the distal vas deferens and the controlled group in no-scalpel vasectomy to observe post-vasectomy sperm free rates.Material & method: A prospective, randomized, partially blinded controlled trial was conducted at Ramathibodi Hospital, Thailand. Urine examination was collected immediate postoperatively and semen analysis were carried out at 2,6,12 weeks post operatively to ascertain azoospermia.Results: The study included 62 men seeking vasectomy. In the NSS irrigation group, post vasectomy urine exam showed more spermatozoa than the controlled group significantly (p=0.000, Mann Whitney tests) but it did not shorten the time needed to reach sterility than the other group as shown in the comparison of total sperm count in both group during 2,6,12 weeks post vasectomy (p>0.05, Mann Whitney tests).Conclusion: Theoretically, irrigation of the vas deferens should flush sperm from the distal vas deferens through the ejaculatory ducts and facilitate the speed with seminal specimens become azoospermic. Our results indicated that irrigation of the distal vas deferens during vasectomy did not accelerated the post vasectomy sperm-free rate than the standard no-scalpel vasectomy. It might be possible that the irrigation technique did not shorten the time to sterility because there was amount of spermatozoa remaining in the distal vas deferens and seminal vesicle.
Archives of Gynecology & Obstetrics ปี 2543, พฤษภาคม ปีที่: 8 ฉบับที่ 9 หน้า