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

Objective: 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 descriptiv...

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Autores:
Tipo de recurso:
Fecha de publicación:
2020
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/23776
Acceso en línea:
https://doi.org/10.1016/j.contraception.2020.02.001
https://repository.urosario.edu.co/handle/10336/23776
Palabra clave:
Adult
Article
Body mass
Colombia
Comparative study
Controlled clinical trial
Controlled study
Descriptive research
Excision
Fascia
Human
Ligation
Local anesthesia
Longitudinal study
Male
Observational study
Percutaneous no scalpel vasectomy
Prospective study
Prostate
Semen analysis
Sperm
Spermatozoon count
Spermatozoon motility
Testis
Treatment failure
Urologist
Vas deferens
Vasectomy
Effectiveness
Excision
Failure risk
Fascial interposition
Ligation
Vasectomy
Rights
License
Abierto (Texto Completo)
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network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
spelling 8dde94e3-5dbb-48a0-96a3-a15841c43bfe-1759092a4-7951-4f37-8888-c19387108069-176ae6686-b40e-4e9f-9373-65316a5c7d8a-17945739760029de9593-0bb1-4384-bab3-f988135a2111-16213f723-54e0-417a-937c-e752b08af97f-12020-05-26T00:05:17Z2020-05-26T00:05:17Z2020Objective: 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. © 2020 Elsevier Inc.application/pdfhttps://doi.org/10.1016/j.contraception.2020.02.001107824https://repository.urosario.edu.co/handle/10336/23776engElsevier USA349No. 5342ContraceptionVol. 101Contraception, ISSN:107824, Vol.101, No.5 (2020); pp. 342-349https://www.scopus.com/inward/record.uri?eid=2-s2.0-85081211530&doi=10.1016%2fj.contraception.2020.02.001&partnerID=40&md5=24e1679115828c31e5139435838d8442Abierto (Texto Completo)http://purl.org/coar/access_right/c_abf2instname:Universidad del Rosarioreponame:Repositorio Institucional EdocURAdultArticleBody massColombiaComparative studyControlled clinical trialControlled studyDescriptive researchExcisionFasciaHumanLigationLocal anesthesiaLongitudinal studyMaleObservational studyPercutaneous no scalpel vasectomyProspective studyProstateSemen analysisSpermSpermatozoon countSpermatozoon motilityTestisTreatment failureUrologistVas deferensVasectomyEffectivenessExcisionFailure riskFascial interpositionLigationVasectomyRisk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive studyarticleArtículohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_6501Claro, Silvia Juliana MirandaLaverde, Jonathan VargasSamper, Elsa MariñoIbáñez Pinilla, MilcíadesQuiroz, Diana Soraya TorresLabrecque, Michel10336/23776oai:repository.urosario.edu.co:10336/237762022-05-02 07:37:14.658301https://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.co
dc.title.spa.fl_str_mv Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
title Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
spellingShingle Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
Adult
Article
Body mass
Colombia
Comparative study
Controlled clinical trial
Controlled study
Descriptive research
Excision
Fascia
Human
Ligation
Local anesthesia
Longitudinal study
Male
Observational study
Percutaneous no scalpel vasectomy
Prospective study
Prostate
Semen analysis
Sperm
Spermatozoon count
Spermatozoon motility
Testis
Treatment failure
Urologist
Vas deferens
Vasectomy
Effectiveness
Excision
Failure risk
Fascial interposition
Ligation
Vasectomy
title_short Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
title_full Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
title_fullStr Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
title_full_unstemmed Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
title_sort Risk of vasectomy failure by ligation and excision with fascial interposition: A prospective descriptive study
dc.subject.keyword.spa.fl_str_mv Adult
Article
Body mass
Colombia
Comparative study
Controlled clinical trial
Controlled study
Descriptive research
Excision
Fascia
Human
Ligation
Local anesthesia
Longitudinal study
Male
Observational study
Percutaneous no scalpel vasectomy
Prospective study
Prostate
Semen analysis
Sperm
Spermatozoon count
Spermatozoon motility
Testis
Treatment failure
Urologist
Vas deferens
Vasectomy
Effectiveness
Excision
Failure risk
Fascial interposition
Ligation
Vasectomy
topic Adult
Article
Body mass
Colombia
Comparative study
Controlled clinical trial
Controlled study
Descriptive research
Excision
Fascia
Human
Ligation
Local anesthesia
Longitudinal study
Male
Observational study
Percutaneous no scalpel vasectomy
Prospective study
Prostate
Semen analysis
Sperm
Spermatozoon count
Spermatozoon motility
Testis
Treatment failure
Urologist
Vas deferens
Vasectomy
Effectiveness
Excision
Failure risk
Fascial interposition
Ligation
Vasectomy
description Objective: 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. © 2020 Elsevier Inc.
publishDate 2020
dc.date.accessioned.none.fl_str_mv 2020-05-26T00:05:17Z
dc.date.available.none.fl_str_mv 2020-05-26T00:05:17Z
dc.date.created.spa.fl_str_mv 2020
dc.type.eng.fl_str_mv article
dc.type.coarversion.fl_str_mv http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.spa.spa.fl_str_mv Artículo
dc.identifier.doi.none.fl_str_mv https://doi.org/10.1016/j.contraception.2020.02.001
dc.identifier.issn.none.fl_str_mv 107824
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/23776
url https://doi.org/10.1016/j.contraception.2020.02.001
https://repository.urosario.edu.co/handle/10336/23776
identifier_str_mv 107824
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.citationEndPage.none.fl_str_mv 349
dc.relation.citationIssue.none.fl_str_mv No. 5
dc.relation.citationStartPage.none.fl_str_mv 342
dc.relation.citationTitle.none.fl_str_mv Contraception
dc.relation.citationVolume.none.fl_str_mv Vol. 101
dc.relation.ispartof.spa.fl_str_mv Contraception, ISSN:107824, Vol.101, No.5 (2020); pp. 342-349
dc.relation.uri.spa.fl_str_mv https://www.scopus.com/inward/record.uri?eid=2-s2.0-85081211530&doi=10.1016%2fj.contraception.2020.02.001&partnerID=40&md5=24e1679115828c31e5139435838d8442
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.acceso.spa.fl_str_mv Abierto (Texto Completo)
rights_invalid_str_mv Abierto (Texto Completo)
http://purl.org/coar/access_right/c_abf2
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.spa.fl_str_mv Elsevier USA
institution Universidad del Rosario
dc.source.instname.spa.fl_str_mv instname:Universidad del Rosario
dc.source.reponame.spa.fl_str_mv reponame:Repositorio Institucional EdocUR
repository.name.fl_str_mv Repositorio institucional EdocUR
repository.mail.fl_str_mv edocur@urosario.edu.co
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