These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Open-ended vasectomy.
    Author: Edwards IS.
    Journal: Adv Contracept Deliv Syst; 1988; 4(2-3):195-224. PubMed ID: 12281616.
    Abstract:
    Open-ended vasectomy goes at least some way towards its primary aim, that of reducing back pressure effects after vasectomy. It need not increase the risk of failure resulting from spontaneous recanalization. To avoid that risk, however, it is essential that the prostatic end of the vas is covered, and that the testicular end is left outside the sheath. It may also be important that it is the sheath of the vas, and not the external spermatic fascia which is closed over the prostatic end. It is reasonable to close the prostatic end by cautery, but there is no need to cauterize more than 1-2 mm of the vas. The demonstrated benefits of open-ended vasectomy are reductions in the rates of 2 well-known complications of vasectomy: congestive epididymitis and painful granuloma. Possible benefits not yet demonstrated might include reduced discomfort immediately after the procedure and increased success rates for vasovasostomy. It is also possible to draw conclusions about other aspects of open-ended vasectomy, and of vasectomy in general, which have been the subject of controversy. Deliberately leaving open the testicular end of the vas does not result in the formation of a painful granuloma. It may not result in the formation of any granuloma at all, in which case, the benefits of this procedure may not depend on sperm granulomas acting as pressure valves. Removing long pieces of vas, widely separating the 2 ends, or cauterizing long sections of them may reduce the rate of spontaneous recanalization, but this is better achieved by other means. Spontaneous recanalization of the van can be reliably prevented by closing its sheath over the closed prostatic end, with the open testicular end left outside the sheath. Current experience with the procedure has been favorable; some postoperative complications have been reduced. However, there seem to be important differences in the rates of spontaneous recanalization which are the result of differences in technique. Nevertheless, there are many unanswered questions and further research is necessary.
    [Abstract] [Full Text] [Related] [New Search]