A Prospective Study of Time and Number of Ejaculations to Azoospermia After Vasectomy by Ligation and Excision
2003; Lippincott Williams & Wilkins; Volume: 170; Issue: 3 Linguagem: Inglês
10.1097/01.ju.0000075505.08215.28
ISSN1527-3792
AutoresMark A. Barone, Hanif Nazerali, Manuel Enrique Escanio-Cortés, Mario Chen-Mok, Amy E. Pollack, David C. Sokal,
Tópico(s)Sexual function and dysfunction studies
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Sep 2003A Prospective Study of Time and Number of Ejaculations to Azoospermia After Vasectomy by Ligation and Excision MARK A. BARONE, HANIF NAZERALI, MANUEL CORTES, MARIO CHEN-MOK, AMY E. POLLACK, and DAVID SOKAL MARK A. BARONEMARK A. BARONE , HANIF NAZERALIHANIF NAZERALI , MANUEL CORTESMANUEL CORTES , MARIO CHEN-MOKMARIO CHEN-MOK , AMY E. POLLACKAMY E. POLLACK , and DAVID SOKALDAVID SOKAL View All Author Informationhttps://doi.org/10.1097/01.ju.0000075505.08215.28AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We obtained detailed information on the time and number of ejaculations to azoospermia after vasectomy by ligation and excision. Materials and Methods.: Men seeking vasectomy at 3 public clinics in Mexico City were invited to participate in this prospective noncomparative study. Vasectomy was performed using the no-scalpel technique. The vas was occluded using 2 silk sutures and the segment of vas between the ligatures was excised. Men were followed biweekly up to 24 weeks after vasectomy or until azoospermia was confirmed. Semen was examined at each visit for sperm concentration and motility. The main outcome measure was azoospermia in uncentrifuged semen samples. Results: The life table rate for time to azoospermia was 81.5/100 men (95% CI 76.2 to 86.9) by the end of the study. Cumulative Kaplan-Meier event probability attained a maximum of 79.5/100 men (95% CI 73.7 to 85.2) at 70 ejaculations. Only 60/100 and 27.9/100 men were azoospermic by 12 weeks and 20 ejaculations, respectively. These end points are the commonly recommended waiting periods when semen analysis is unavailable. Of the 217 men 36 (16.6%) did not achieve azoospermia by 24 weeks, of whom 25 (11.5% of all participants) were considered to have vasectomy failure. Conclusions: Our results suggest that it is not possible to develop guidelines for clearance based only on the time or number of ejaculations when ligation and excision are performed. In addition, of the methods for vas occlusion during vasectomy ligation and excision may not provide the best success rates. References 1 : Clinical aspects of vasectomies performed in the United States in 1995. Urology1998; 52: 685. Crossref, Medline, Google Scholar 2 : Review of current practice to establish success after vasectomy. Br J Surg2001; 88: 290. Google Scholar 3 : Patient noncompliance after vasectomy. Fertil Steril1997; 68: 552. Google Scholar 4 : Medical and Service Delivery Guidelines for Family Planning. London: Stephen Austin and Sons, Ltd.1997. Google Scholar 5 : The Essentials of Contraceptive Technology. Baltimore: Population Information Program Center for Communicating Programs1997. Google Scholar 6 : Male sterilization. In: . Philadelphia: Lippincott Williams & Wilkins2000: 1. chapt. 47. Google Scholar 7 : Results of a pilot study of the time to azoospermia after vasectomy in Mexico City. Contraception1997; 56: 215. Crossref, Medline, Google Scholar 8 : Technique and results of vasectomy in Korea. In: Control of Male Fertility. Edited by . Hagerstown: Harper & Row Publishers1975: 68. Google Scholar 9 : Effectiveness and complications associated with 2 vasectomy occlusion techniques. J Urol2002; 168: 2495. Link, Google Scholar 10 : Contraceptive failure in China. Contraception2002; 66: 173. Google Scholar 11 WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction. Cambridge: Cambridge University Press1992. Google Scholar 12 : Semen parameters, including WHO and strict criteria morphology, in a fertile and subfertile population: an effort towards standardization of in-vivo thresholds. Hum Reprod2001; 16: 1165. Google Scholar 13 Contraceptive efficacy of testosterone-induced azoospermia and oligozoospermia in normal men. Fertil Steril1996; 65: 821. Google Scholar 14 : General and anomalous sperm disappearance characteristics found in a large vasectomy series. Fertil Steril1989; 51: 859. Google Scholar 15 : Persistence or reappearance of nonmotile sperm after vasectomy: does it have clinical consequences?. Fertil Steril1997; 67: 332. Google Scholar 16 : A comparative study of the no scalpel and standard incision approaches to vasectomy in 5 countries. J Urol1999; 162: 1621. Link, Google Scholar 17 Royal College of Obstetricians and Gynaecologists: Male and Female Sterilisation, Evidence-Based Clinical Guidelines No. 4. London: RCOG Press, 1999 Google Scholar 18 : Surgical management of male infertility and other scrotal disorders. In: . Philadelphia: W. B. Saunders Co.1998: 1331. Google Scholar 19 : Vasectomy: efficacy of placing the cut vas in different fascial planes. Fertil Steril1980; 34: 292. Google Scholar 20 : Termination of a randomized controlled trial of two vasectomy techniques. Control Clin Trials2003; 24: 78. Google Scholar From EngenderHealth (MAB, AEP), New York, New York, Family Health International (HN, MC-M, DS), Research Triangle Park, North Carolina, and Instituto Mexicano del Seguro Social (MC), Mexico City, Mexico© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byManka M, Miller A, Sharma V, Butaney M, Trost L and Ziegelmann M (2020) Discrepancy between Post-Vasectomy Semen Analysis Recommendation and Practice Patterns in the Post-2012 American Urological Association Guideline EraJournal of Urology, VOL. 204, NO. 6, (1312-1317), Online publication date: 1-Dec-2020.Coward R, Badhiwala N, Kovac J, Smith R, Lamb D and Lipshultz L (2013) Impact of the 2012 American Urological Association Vasectomy Guidelines on Post-Vasectomy OutcomesJournal of Urology, VOL. 191, NO. 1, (169-174), Online publication date: 1-Jan-2014.Sharlip I, Belker A, Honig S, Labrecque M, Marmar J, Ross L, Sandlow J and Sokal D (2012) Vasectomy: AUA GuidelineJournal of Urology, VOL. 188, NO. 6S, (2482-2491), Online publication date: 1-Dec-2012.Klotz K, Coppola M, Labrecque M, Brugh V, Ramsey K, Kim K, Conaway M, Howards S, Flickinger C and Herr J (2008) Clinical and Consumer Trial Performance of a Sensitive Immunodiagnostic Home Test That Qualitatively Detects Low Concentrations of Sperm Following VasectomyJournal of Urology, VOL. 180, NO. 6, (2569-2576), Online publication date: 1-Dec-2008.Levine L, Abern M and Lux M (2018) Persistent Motile Sperm After Ligation Band VasectomyJournal of Urology, VOL. 176, NO. 5, (2146-2148), Online publication date: 1-Nov-2006.Labrecque M, Barone M, Pile J and Sokal D (2018) Re: How Little is Enough? The Evidence for Post-Vasectomy TestingJournal of Urology, VOL. 175, NO. 2, (791-792), Online publication date: 1-Feb-2006. Volume 170Issue 3September 2003Page: 892-896 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordssterilization, sexualvasectomyinfertility, maletestisoligospermiaMetricsAuthor Information MARK A. BARONE More articles by this author HANIF NAZERALI More articles by this author MANUEL CORTES More articles by this author MARIO CHEN-MOK More articles by this author AMY E. POLLACK More articles by this author DAVID SOKAL More articles by this author Expand All Advertisement PDF downloadLoading ...
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