A Male Surgical Contraceptive Method Based on Recommendations and Techniques Used in Vasectomy

Abstract

Background: Vasectomy is a well-established method of male sterilization, offering a reliable and permanent contraceptive solution. Despite its effectiveness, the procedure remains underutilized due to limited counseling and awareness among patients.

Objective: The objective of this study was to evaluate the efficacy and safety of a standardized vasectomy technique based on the 2012 American Urological Association (AUA) guidelines and to identify factors influencing postoperative outcomes and patient satisfaction.

Methods: This prospective cohort study was conducted at the Department of Zoology, Rawalpindi Women University, from January 2022 to December 2023. A total of 150 male patients aged 25 to 50 years seeking permanent contraception were enrolled. Preoperative evaluations included detailed medical history, physical examination, and baseline semen analysis. The vasectomy procedures involved isolation, division, and management of the vasal ends using techniques such as proximal fascial interposition and thermal luminal fulguration. Postoperative care included instructions on scrotal support, avoidance of strenuous activities, and use of alternative contraception until azoospermia was confirmed through post-vasectomy semen analysis (PVSA) conducted at three months post-procedure. Data were analyzed using SPSS version 25, with statistical significance set at p < 0.05.

Results: The mean age of participants was 37.5 years (range: 25-50 years). The overall efficacy rate was 98.7%, with 140 participants (93.3%) achieving azoospermia and 8 participants (5.3%) having less than 100,000 non-motile sperm/mL at three months post-procedure. Complications included infection (1.3%), hematoma (2.0%), chronic pain (2.7%), and sperm granuloma (0.7%). The mean VAS scores for pain were 2.3 at one week, 1.1 at one month, and 0.5 at three months post-procedure. Patient satisfaction was high, with 95% of participants reporting satisfaction with the procedure.

Conclusion: This study demonstrated that vasectomy, when performed using standardized techniques, is a highly effective and safe method of male sterilization with high patient satisfaction and low complication rates. Enhanced preoperative counseling and follow-up are essential to optimize outcomes and increase the utilization of vasectomy as a contraceptive method.