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

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dc.contributor.authorMiranda Claro, Silvia Juliana
dc.contributor.authorVargas Laverde, Jonathan
dc.contributor.authorMariño Samper, Elsa
dc.contributor.authorIbáñez-Pinilla, Milcíades
dc.contributor.authorTorres Quiroz, Diana Soraya
dc.contributor.authorlabrecque, michel
dc.date.accessioned2020-04-26T19:52:00Z
dc.date.available2020-04-26T19:52:00Z
dc.date.issued2020
dc.description.abstractenglishObjective 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 Bogotá, 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.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/j.contraception.2020.02.001
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.issn0010-7824
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/2393
dc.language.isoeng
dc.publisherElsevierspa
dc.publisher.journalContraceptionspa
dc.relation.ispartofseriesContraception, 0010-7824, 2020spa
dc.relation.urihttps://www.contraceptionjournal.org/article/S0010-7824(20)30053-6/pdf
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf221
dc.rights.creativecommons2020
dc.rights.localAcceso cerradospa
dc.subject.decsConducta de reducción del riesgospa
dc.subject.decsRiesgo aceptablespa
dc.subject.decsEstudio comparativospa
dc.subject.keywordsVasectomyspa
dc.subject.keywordsLigationspa
dc.subject.keywordsExcisionspa
dc.titleRisk of vasectomy failure by ligation and excision with fascial interposition: a prospective descriptive studyspa
dc.title.translatedRisk of vasectomy failure by ligation and excision with fascial interposition: a prospective descriptive study
dc.typearticlespa
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localartículospa

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