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Reproductive Health |
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Findings Suggest How to Improve Vasectomy Success Rates |
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Early recanalization — frequently associated with vasectomy failure — is more common than previously recognized, according to a USAID-supported study conducted by Family Health International, Laval University, and EngenderHealth. The study, published in the journal BMC Urology, charted patterns of early recanalization (a spontaneous reconnection of the two ends of the severed vas deferens) in two rigorous studies of vasectomy techniques. One study tested the effectiveness of fascial interposition among 826 men in seven countries, while the other examined the effectiveness of cautery among 389 men in four countries. The researchers estimated that early recanalization occurred in 13 percent of study participants overall — a surprisingly high percentage for a method considered 99 percent effective — and was associated with more than four-fifths of vasectomy failures overall. The risk of recanalization depended on the vasectomy technique; it was highest for ligation and excision without fascial interposition (25 percent) and lowest for thermal cautery with fascial interposition (0 percent). The authors caution that further research is needed to clarify the full implications of these results for clinical practice because what seem like small differences in surgical technique may lead to significant differences in effectiveness. However, researchers said these findings reinforce recommendations to avoid ligation and excision, and support the use of cautery with fascial interposition as probably the most effective way of occluding the vas. High risk of early recanalization with ligation and excision without fascial interposition may partly explain the unacceptably high contraceptive failure rate following vasectomy observed in countries where this occlusion technique is still the most commonly performed. Read the full study. Source |
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