A Male Surgical Contraceptive Method Based on Recommendations and Techniques Used in Vasectomy
DOI:
https://doi.org/10.61919/jhrr.v4i2.940Keywords:
Vasectomy, male sterilization, contraceptive methods, postoperative outcomes, patient satisfaction, azoospermiaAbstract
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.
Downloads
References
Sheynkin YR. History of Vasectomy. Urol Clin North Am. 2009;36:285-295.
Sharlip ID, Belker AM, Honig S, Labrecque M, Marmar JL, Ross LS, Sandlow JI, Sokal DC, American Urological Association. Vasectomy: AUA Guideline. J Urol. 2012;188:2482-2491.
Shih G, Dubé K, Dehlendorf C. “We Never Thought of a Vasectomy”: A Qualitative Study of Men and Women’s Counseling Around Sterilization. Contraception. 2013;88:376-381.
Dohle GR, Diemer T, Kopa Z, Krausz C, Giwercman A, Jungwirth A, Grupo de Trabajo de la Asociación Europea de Urología sobre la Infertilidad Masculina. European Association of Urology Guidelines on Vasectomy. Actas Urol Esp. 2012;36(5):276-281.
Moaddab A, McCullough LB, Chervenak FA, Fox KA, Aagaard KM, Salmanian B, Raine SP, Shamshirsaz AA. Health Care Justice and Its Implications for Current Policy of a Mandatory Waiting Period for Elective Tubal Sterilization. Am J Obstet Gynecol. 2015;212:736-739.
Denniston GC. Vasectomy by Electrocautery: Outcomes in a Series of 2,500 Patients. J Fam Pract. 1985;21:35-40.
Schmidt SS, Minckler TM. The Vas After Vasectomy: Comparison of Cauterization Techniques. Urology. 1992;40:468-470.
Bradshaw A, Punjani N, Hayden R, Dudley V, Matos-Vargas E, Goldstein M. Home Testing Does Not Improve Post-Vasectomy Semen Analysis Compliance. J Urol. 2020;203.
Trussler J, Browne B, Merino M, Kuftinec D, McCullough A. Post-Vasectomy Semen Analysis Compliance With Use of a Home-Based Test. Can J Urol. 2020;27:10388-10393.
Asanad K, Nusbaum DJ, Samplaski MK. National Opioid Prescription Patterns and Patient Usage After Routine Vasectomy. Andrologia. 2020;52.
Barham DW, McMann LP, Musser JE, et al. Routine Prescription of Opioids for Post-Vasectomy Pain Control Associated With Persistent Use. J Urol. 2019;202:806-810.
Casey R, Zadra J, Khonsari H. A Comparison of Etodolac (Ultradol) With Acetaminophen Plus Codeine (Tylenol #3) in Controlling Post-Surgical Pain in Vasectomy Patients. Curr Med Res Opin. 1997;13:555-563.
Jamieson DJ, Kaufman SC, Costello C, Hillis SD, Marchbanks PA, Peterson HB. A Comparison of Women’s Regret After Vasectomy Versus Tubal Sterilization. Obstet Gynecol. 2002;99:1073-1079.
Miller WB, Shain RN, Pasta DJ. The Pre- and Post-Sterilization Predictors of Post-Sterilization Regret in Husbands and Wives. J Nerv Ment Dis. 1991;179:602-608.
Peterson HB, Huber DH, Belker AM. Vasectomy: An Appraisal for the Obstetrician-Gynecologist. Obstet Gynecol. 1990;76(3 pt 2):568-572.
Freund M, Davis JE. Disappearance Rate of Spermatozoa From the Ejaculate Following Vasectomy. Fertil Steril. 1969;20:163-170.
Errey BB, Edwards IS. Open-Ended Vasectomy: An Assessment. Fertil Steril. 1986;45:843-846.
Furr J, Baker R, Pham Q, Sindhwani P. Comparative Analysis of Anticipated Pain Versus Experienced Pain in Patients Undergoing Office Vasectomy. Can J Urol. 2017;24:8744-8748.
Tan WP, Levine LA. Micro-Denervation of the Spermatic Cord for Post-Vasectomy Pain Management. Sex Med Rev. 2018;6:328-334.
Tan WP, Levine LA. An Overview of the Management of Post-Vasectomy Pain Syndrome. Asian J Androl. 2016;18:332-337.
Kobori Y. Home Testing for Male Factor Infertility: A Review of Current Options. Fertil Steril. 2019;111:864-870.
Katherins M. Original Investigations Into the Clearance of Spermatozoa After Vasectomy. Fertil Steril. 2019;111:60.
Hoeh MP. Evaluation and Management of Chronic Scrotal Content Pain. Curr Urol Rep. 2015;16:36.
Kaplan KA, Huether CA. A Clinical Study of Vasectomy Failure and Recanalization. J Urol. 1975;113:71-74.
Hallan RI, May AR. Vasectomy: How Much Is Enough?. Br J Urol. 1988;62:377-379.
Reynolds RD. Vas Deferens Occlusion During No-Scalpel Vasectomy. J Fam Pract. 1994;39:577-582.
Stockton DM, Davis LE, Bolton KM. No-Scalpel Vasectomy: A Technique for Family Physicians. Am Fam Physician. 1992;46:1153-1167.
Li PS, Li SQ, Schlegal PN, Goldstein M. External Spermatic Sheath Injection for Vasal Nerve Block. Urology. 1992;39:173-176.
Kim ED, Lipshultz LI. Standards of Care for Vasectomy. Contemp Urol. 1996;8(11):41-55.
Khan AB, Conn IG. Use of EMLA During Local Anaesthetic Vasectomy. Br J Urol. 1995;75:671.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Asma Binish, Javaria Tufail, Iqra Mukhtar, Aqsa Arif, Hamra Bano, Mahnoor Arif, Bushra Nisa, Shaista Jabeen, Rabea Ejaz
This work is licensed under a Creative Commons Attribution 4.0 International License.
