Abstract
BackgroundVasectomy is one of the permanent methods of contraception; however, the risk of conception still exists. Early failure, defined as a postoperative semen analysis showing persistent motile sperm, occurs in 1 in every 250 patients. Late failure, defined as the rejoining of the severed ends of the vas deferens, occurs in 1 in every 2000 patients.Case presentationA healthy 37-year-old British male presented to our clinic because his wife had conceived seven years after he had undergone a vasectomy. The result of his semen analysis after the vasectomy was negative, and the histopathological report confirmed that the sample contained tissue from both the left and right vas deferens. His wife conceived seven years after the procedure, and semen analysis at that time confirmed a total of 0.5 million sperm per milliliter of semen in a total semen sample of 6.3 ml. The total number of motile sperm recorded was 2.5 million.ConclusionThis case shows that late recanalization can occur up to seven years after a vasectomy. Patients should be informed prior to the procedure that late recanalization, although rare, may still occur. Post-vasectomy paternity necessitates further counseling to ensure that the patient and the patient’s partner fully understand the implications and options available to them.
Highlights
Vasectomy is one of the permanent methods of contraception; the risk of conception still exists
Vasectomy failure can be due to technical error during the procedure, early recanalization, late recanalization, or patients’ failing to use alternative contraceptive methods immediately after the procedure when sperm could still be present in the ejaculate [4]
There is a general consensus that men are considered sterile if < 100,000 non-motile spermatozoa per milliliter are present in the ejaculate sample taken three months after the vasectomy [4, 5]
Summary
This case shows that late recanalization can occur up to seven years after a vasectomy. Patients should be informed prior to the procedure that late recanalization, rare, may still occur. Post-vasectomy paternity necessitates further counseling to ensure that the patient and the patient’s partner fully understand the implications and options available to them
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