Skip to main content
NCBI home page
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 2001 May;83(3):177–179.

Post vasectomy analysis: call for a uniform evidence-based protocol.

K A Sivardeen 1, M Budhoo 1
PMCID: PMC2503594  PMID: 11432136

Abstract

BACKGROUND: Vasectomy is a safe and reliable means of contraception that is used by 42 million couples world-wide. There are no standardised guidelines in the follow-up of these patients to assess the efficacy of the procedure, however. Through this paper we aim to recommend a guideline that is both clinically effective and cost effective, and would avoid medicolegal debate. PATIENTS AND METHODS: A questionnaire was sent to consultant general surgeons and urologists working both within and outside the North-West region, to assess the range of protocols used in the follow-up of patients undergoing vasectomy. RESULTS: Of respondents, 75% sent the vas deferens routinely for histology: 90.4% requested 2 sperm samples routinely whilst 4.8% requested 1 sample and 4.8% requested 3 samples. 95.2% requested further sperm samples if non-motile sperm were present. 98.8% performed their first sperm sample by 12 weeks. CONCLUSIONS: There is a wide range of protocols used in the follow-up of patients post-vasectomy. Most do not appear to be evidence-based. We recommend a guideline which re-emphasises the importance of pre-operative counselling, only 1 routine sperm sample taken 16 weeks post-vasectomy, and further samples taken only if motile sperm is seen. Non-motile sperm is not an indication for further sperm samples. We believe this guideline would be both clinically effective and cost effective.

Full text

PDF
177

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alderman P. M. General and anomalous sperm disappearance characteristics found in a large vasectomy series. Fertil Steril. 1989 May;51(5):859–862. doi: 10.1016/s0015-0282(16)60680-5. [DOI] [PubMed] [Google Scholar]
  2. Amelar R. D., Dubin L., Schoenfeld C. Sperm motility. Fertil Steril. 1980 Sep;34(3):197–215. doi: 10.1016/s0015-0282(16)44949-6. [DOI] [PubMed] [Google Scholar]
  3. Benger J. R., Swami S. K., Gingell J. C. Persistent spermatozoa after vasectomy: a survey of British urologists. Br J Urol. 1995 Sep;76(3):376–379. [PubMed] [Google Scholar]
  4. Davies A. H., Sharp R. J., Cranston D., Mitchell R. G. The long-term outcome following "special clearance" after vasectomy. Br J Urol. 1990 Aug;66(2):211–212. doi: 10.1111/j.1464-410x.1990.tb14907.x. [DOI] [PubMed] [Google Scholar]
  5. De Knijff D. W., Vrijhof H. J., Arends J., Janknegt R. A. Persistence or reappearance of nonmotile sperm after vasectomy: does it have clinical consequences? Fertil Steril. 1997 Feb;67(2):332–335. doi: 10.1016/S0015-0282(97)81920-6. [DOI] [PubMed] [Google Scholar]
  6. Edwards I. S., Farlow J. L. Non-motile sperms persisting after vasectomy: do they matter? Br Med J. 1979 Jan 13;1(6156):87–88. doi: 10.1136/bmj.1.6156.87-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ehn B. E., Liljestrand J. A long-term follow-up of 108 vasectomized men. Good counselling routines are important. Scand J Urol Nephrol. 1995 Dec;29(4):477–481. doi: 10.3109/00365599509180030. [DOI] [PubMed] [Google Scholar]
  8. Esho J. O., Cass A. S. Recanalization rate following methods of vasectomy using interposition of fascial sheath of vas deferens. J Urol. 1978 Aug;120(2):178–179. doi: 10.1016/s0022-5347(17)57094-9. [DOI] [PubMed] [Google Scholar]
  9. Freund M., Davis J. E. Disappearance rate of spermatozoa from the ejaculate following vasectomy. Fertil Steril. 1969 Jan-Feb;20(1):163–170. doi: 10.1016/s0015-0282(16)36914-x. [DOI] [PubMed] [Google Scholar]
  10. Khan M. A., Cranston D. Recanalization of the vas following vasectomy. Br J Urol. 1997 Mar;79(3):484–484. doi: 10.1046/j.1464-410x.1997.11235.x. [DOI] [PubMed] [Google Scholar]
  11. Maatman T. J., Aldrin L., Carothers G. G. Patient noncompliance after vasectomy. Fertil Steril. 1997 Sep;68(3):552–555. doi: 10.1016/s0015-0282(97)00251-3. [DOI] [PubMed] [Google Scholar]
  12. Marshall S., Lyon R. P. Transient reappearance of sperm after vasectomy. JAMA. 1972 Mar 27;219(13):1753–1754. [PubMed] [Google Scholar]
  13. O'Brien T. S., Cranston D., Ashwin P., Turner E., MacKenzie I. Z., Guillebaud J. Temporary reappearance of sperm 12 months after vasectomy clearance. Br J Urol. 1995 Sep;76(3):371–372. doi: 10.1111/j.1464-410x.1995.tb07717.x. [DOI] [PubMed] [Google Scholar]
  14. Philp T., Guillebaud J., Budd D. Complications of vasectomy: review of 16,000 patients. Br J Urol. 1984 Dec;56(6):745–748. doi: 10.1111/j.1464-410x.1984.tb06161.x. [DOI] [PubMed] [Google Scholar]
  15. Philp T., Guillebaud J., Budd D. Late failure of vasectomy after two documented analyses showing azoospermic semen. Br Med J (Clin Res Ed) 1984 Jul 14;289(6437):77–79. doi: 10.1136/bmj.289.6437.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Smith J. C., Cranston D., O'Brien T., Guillebaud J., Hindmarsh J., Turner A. G. Fatherhood without apparent spermatozoa after vasectomy. Lancet. 1994 Jul 2;344(8914):30–30. doi: 10.1016/s0140-6736(94)91052-9. [DOI] [PubMed] [Google Scholar]
  17. Smith J. C. Semen examinations after vasectomy. Lancet. 1971 Jan 2;1(7688):38–38. [PubMed] [Google Scholar]
  18. Temple J. G., Jameson R. M. Semen examinations after vasectomy. Lancet. 1970 Dec 12;2(7685):1258–1258. doi: 10.1016/s0140-6736(70)92227-0. [DOI] [PubMed] [Google Scholar]
  19. Thompson B., MacGregor J. E., MacGillivray I., Garvie W. H. Experience with sperm counts following vasectomy. Br J Urol. 1991 Sep;68(3):230–233. doi: 10.1111/j.1464-410x.1991.tb15312.x. [DOI] [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES