A Randomized Clinical Trial of the Effect of Intraoperative Saline Perfusion on Postvasectomy Azoospermia

Abstract

BACKGROUND We wanted to determine whether a saline fl ush during vasectomy would reduce the time needed to reach azoospermia.METHODS During vasectomy men were randomly assigned to fl ush the prostatic end of the vas deferens with 10 mL of normal saline (intervention group, n = 50), while the remaining men (n = 56) served as controls. Sperm counts were performed on the immediate postprocedure urine specimen and on semen samples at 1, 6, and 12 weeks after vasectomy. RESULTSThe postprocedure urine specimens from the intervention and control groups contained 29.2 x 106 and 0.004 x 106 sperm, respectively (P <.001). Total sperm counts in the ejaculate for intervention and control groups at 1, 6, and 12 weeks were (in millions of sperm): 14.1 and 13.8, 0.4 and 8.0, and 0.0 and 0.011, respectively (P >.05 at all time points). There was no difference in the rate at which the men in the 2 groups achieved azoospermia.CONCLUSIONS Vasal perfusion with saline during vasectomy was effective in removing sperm from the distal vas; however, perfusion did not increase the rate at which men achieve azoospermia.

Sites of residual spermatozoa after irrigation of the distal vas deferens using normal saline solution during vasectomy in a rat model

“…We have previously reported using NSS for the irrigation of the distal vas deferens. We have found that the technique is successful in removing a large number of spermatozoa from the tract (Leungwattanakij et al, 2001), but still does not significantly accelerate the sperm-free rate as needed, consistent with other studies (Mason et al, 2002;Pearce et al, 2002;Eisner et al, 2004). Thus, our aim in the present study is to identify where the failure of the residual spermatozoa may be located after our NSS irrigation technique using the in vivo rat model.…”

Male Contraception

“…Vasectomy is usually performed under local anesthesia via scrotal incisions and involves excising a segment of vas deferens. However, flushing with saline or water [48][49][50][51][52] or spermicides (nitrofurazone, 53 euflavine, 54,55 or chlorhexidine 56 ) during surgery does not accelerate sperm clearance, but the evidence remains weak. 36 The Chinese-developed "no-scalpel" technique 37 minimizes skin incision and reduces immediate side effects (bleeding, infection) tenfold to 0.3% compared with conventional vasectomy.…”

Effect of ductus deferens lavage on the time to achieve azoospermia in patients undergoing vasectomy

“…Approximately 40 to 60 million men worldwide have been sterilized, and approximately 500,000 surgeries are performed annually. Vasectomy accounts for 5% to 10% of contraceptive use among all available methods 1 - 3 .…”