Intraoperative Distal Vasal Flushing—Does It Improve the Rate of Early Azoospermia Following No-scalpel Vasectomy? A Prospective, Randomized, Controlled Study

Abstract

To assess the impact of intraoperative distal vasal flushing during no-scalpel vasectomy on hastening the sperm clearance from the vas deferens and subsequent postvasectomy time to azoospermia. A total of 906 men undergoing vasectomy at our center from October 2007 to August 2008 were included in this prospective, randomized, controlled study. Patients were alternately allocated to 1 of 2 groups. Group A were patients who underwent no scalpel vasectomy alone; Group B patients, in addition to no scalpel vasectomy, underwent flushing of the distal vasal segment with 30 mL of sterile water. Postvasectomy semen analysis was done at 4, 8, and 12 weeks. The age, operative time, number of ejaculations, and proportion of patients' azoospermic at 4, 8, and 12 weeks after vasectomy were compared between the 2 groups. A total of 727 men were available for final analysis. A significantly higher proportion of patients in group B were azoospermic at 4 and 8 weeks when compared with group A (group B: 53.40% and 80.68%; group A: 33.86% and 49.6% at 4 and 8 weeks, respectively). There was no statistically significant difference in the mean age, operative time, and number of ejaculations between the 2 groups. Distal vasal flushing with 30 mL of sterile water may shorten the time to azoospermia for between 20% and 30% of vasectomy patients. Thus, this procedure may be an option for some who choose the vasal flush to avoid the long duration of postvasectomy alternate contraceptive methods.