Authors: Katsoulis, IE; Walker, S.R.

Source: Annals of The Royal College of Surgeons of England, Volume 87, Number 2, March 2005 , pp. 131-135(5)

Publisher: The Royal College of Surgeons of England

Abstract:

Introduction: Vasectomy is a common method of contraception in the UK. However, there is a wide variation in management protocols. The aim of the present study was to identify differences within the hospitals of Morecambe Bay NHS Trust and to recommend a uniform practice.

Patients and Methods: Retrospective case notes review of 395 vasectomy procedures performed within the Morecambe Bay NHS Trust in a 1-year period.

Results: Inconsistency was found with regards to the anaesthetic technique, the vas histology request and the timing of the semen analysis. The non-compliance rate for postvasectomy semen analysis was 33.4%. The complication and failure rates were 4.04% and 0.51%, respectively. Motile sperm (n = 4) was submitted at an average time of 8 weeks' postvasectomy. In half of those cases, vasectomy proved unsuccessful. Immotile sperm (n = 41) was submitted at an average time of 9.5 weeks and, in 80% of those men, semen cleared at an average time of 15.5 weeks' postvasectomy. An azoospermic (n = 285) sample was submitted at an average time of 10.5 weeks. Eleven of those men submitted a second sample with immotile sperm at an average time of 12 weeks' postvasectomy and that was eventually clear at 18 weeks in the majority of cases.

Conclusions: A uniform vasectomy practice should include vasectomy under local anaesthesia if possible, no vas histology and a request for a single sample at 12 weeks. If this is clear, vasectomy should be considered successful. If any sperm are present, then a further sample should be requested at 16 weeks' postvasectomy. Immotile sperm at that time should not justify any further samples and a 'special clearance' should be issued to those men.

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Keywords: VASECTOMY; STERILISATION; SEMEN ANALYSIS

Document Type: Research article

DOI: http://dx.doi.org/10.1308/1478708051487

Affiliations: 1: Department of Surgery, Royal Lancaster Infirmary, Lancaster, UK

Publication date: 2005-03-01

More about this publication?

• The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.
  
  The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.
  
  Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database
  
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