Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
| Autor: | Diana Soraya Torres Quiroz, Elsa Mariño Samper, Silvia Juliana Miranda Claro, Michel Labrecque, Jonathan Vargas Laverde, Milciades Ibáñez Pinilla |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Local anesthesia
Male Percutaneous Effectiveness Estudio comparativo Vas Deferens 0302 clinical medicine Controlled clinical trial Observational study Testis Prospective Studies Treatment Failure 030212 general & internal medicine Fascia Prospective cohort study 030219 obstetrics & reproductive medicine Sperm Count medicine.diagnostic_test Spermatozoon motility Age Factors Vasectomy Vas deferens Prostate Obstetrics and Gynecology Middle Aged Surgical Instruments medicine.anatomical_structure Body mass Riesgo aceptable Longitudinal study Human Risk Adult medicine.medical_specialty Failure risk Semen analysis Colombia Excision Article Spermatozoon count 03 medical and health sciences Descriptive research Conducta de reducción del riesgo medicine Humans Prospective study Ligation business.industry Percutaneous no scalpel vasectomy Confidence interval Sperm Surgery Fascial interposition Urologist Reproductive Medicine Treatment failure Comparative study business Controlled study |
| Zdroj: | Repositorio EdocUR-U. Rosario Universidad del Rosario instacron:Universidad del Rosario Repositorio U. El Bosque Universidad El Bosque instacron:Universidad El Bosque |
| Popis: | Objective To evaluate the occlusive failure risk of ligation and excision with fascial interposition vasectomy technique. There are doubts about the effectiveness of this technique largely used in Asia and Latin America. Study design We conducted a prospective longitudinal observational descriptive study among men who underwent a vasectomy performed under local anesthesia in a clinic specializing in sexual and reproductive health services in Bogota, Colombia. Three urologists used the Percutaneous No-Scalpel Vasectomy technique to isolate the vas deferens. They then ligated the vas, excised a 1 cm segment between ligations, and ligated the fascia on the prostatic end to cover the testicular end. We requested all patients to submit a semen sample three months after the vasectomy. We defined probable and confirmed vasectomy failure as 1–4.9 million sperm/ml and 5 million sperm/ml or more or any number of motile sperm observed on the last semen sample available, respectively. Results Among 1149 participants, 581 (51%) had at least one post-vasectomy semen analysis. The overall failure risk was 5.2% (30/581; 95% confidence interval [CI] 3.6%–7.3%) with probable and confirmed failure risk of 1.9% (11/581; 95% CI 1.1%–3.4%) and 3.3% (19/581; 95% CI 2.1%–5.1%), respectively. Older men and one urologist had statistically significant higher risk of overall failure. Conclusion Our study confirmed that the ligation and excision with fascial interposition vasectomy technique is associated with an unacceptable risk of failure. Implications Surgeons who use the ligation and excision with fascial interposition vasectomy technique and countries with large vasectomy programs in Asia and Latin America that still recommend this technique should consider adopting alternatives to reduce the failure risk to below 1% as recommended by the American Urological Association. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|