Around 42 million couples worldwide rely on vasectomy as a method of family-planning.
Every year 800,000 vasectomies are performed in the US.
Recanalisation: 0.5% of all vasectomies (is defined as the presence of any spermatozoa after one or more previously azoospermic samples were properly collected and documented).
Why are doctors sued following vasectomy?
- Failure to be sterile (unwanted pregnancy)
- Failure to inform regarding positive semen sample post-operatively
- Chronic testicular pain
- Atrophy or loss of testicular volume
Can be due to technical errors, recanalization, or unprotected intercourse before azoospermia is documented
- Intraluminal needle cautery (vas not transected, no segment removed): Less than 1%
- Cautery both ends and fascial interruption: 1.2 % or less
- Cautery (prostatic end) only and fascial interruption (clip): 0.02 to 2.4%
- Cautery of both ends and excision of a segment: 4.8% or less
- Ligation and fascial interruption: 16.7% or less
- Ligation and excision of segment: 1.5 to 29%
To confirm sterility: Obtain a semen analysis 3 months on the postop period; the patient should have had at least 20 ejaculates since the time of vasectomy. Azoospermia in a semen sample is definitive evidence of infertility.
Sokal DC, Labrecque M.Â Effectiveness of Vasectomy Techniques. Urol Clin N Am 36 (2009) 317â€“329.