The aims of this prospective, non-comparative study were to determine time to azoospermia and vasectomy success rate based on the results of semen analysis. A total of 334 men seeking vasectomy at a clinic in Urmia city, Islamic Republic of Iran were followed bi-weekly up to 24 weeks after vasectomy or until azoospermia was confirmed via semen analysis. The cumulative life table rate for azoospermia was 93/100 men (95% CI: 88.1 to 97.9). The median time to azoospermia was 10 weeks. By week 24 of follow-up, 3.3% of participants had failed to achieve azoospermia. One pregnancy was reported during the study period and attributed to user failure. The results suggest that men can begin to rely on vasectomy for contraception 12 weeks after no-scalpel vasectomy using fascial interposition performed by an experienced surgeon

Evaluating success of no-scalpel vasectomy by ligation and excision with fascial interposition in a large prospective study in Islamic Republic of Iran Ãvaluation de Ä¾efficacitÃ© de la vasectomie sans bistouri par ligature et excision avec interposition fasciale dans une Ã©tude prospective Ã grande Ã©chelle en RÃ©publique islamique d'Iran

Vasectomía

OBJECTIVES
To estimate the risk of post-vasectomy infections in various settings and across various surgical techniques and sanitization practices.


PATIENTS AND METHODS
Retrospective review of the records of 133,044 vasectomized patients from four large practices/network of practices using the no-scalpel vasectomy (NSV) technique in Canada (2011-2021), Colombia (2015-2020), New Zealand (2018-2021), and the United Kingdom (2006-2019). We defined infection as any mention in medical records of any antibiotics prescribed for a genital or urinary condition following vasectomy.


RESULTS
Post-vasectomy infection risks were 0.8% (219 infections/26,809 procedures), 2.1% (390/18,490), 1.0% (100/10,506), and 1.3% (1,007/77,239) in Canada, Colombia, New Zealand, and the UK, respectively. Audit period comparison suggests a limited effect on the risk of infection of excising a short vas segment, applying topical antibiotic on scrotal opening, wearing a surgical mask in Canada, type of skin disinfectant, and use of non-sterile gloves in New Zealand. Risk of infection was lower in Colombia when mucosal cautery and fascial interposition [FI] were used for vas occlusion compared to ligation, excision, and FI (0.9% vs. 2.1%, p<0.00001). Low level of infection certainty in 56% to 60% of patients who received antibiotics indicates that the true risk might be overestimated. Lack of information in medical records and patients not consulting their vasectomy providers might have led to underestimation of the risk.


CONCLUSION
Risk of infection after vasectomy is low, about 1%, among international high-volume vasectomy practices performing NSV and various occlusion techniques. Apart from vasectomy occlusion technique, no other factor modified the risk of post-vasectomy infection.

Elsa Mariño Samper

Papers

Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study