Reply

Abstract

We thank the editor for his thoughtful comments. We agree that vasal flush is not a new thing and that data from earlier studies are contradictory; therefore we have tried to resolve this issue by performing a large, properly randomized, controlled trial. Roshani et al, in a recent study of 126 patients, also reported significantly higher azoospermic rates of 100% at 12 weeks and 88.1% at 16 weeks in patients who underwent distal vasal flushing with 40 mL of sterile water and saline solution, respectively, when compared with patients without vasal flushing (26.2% azoospermic at 16 weeks). 1 Roshani A. Falahatkar S. Khosropanah I. et al. Vasal irrigation with sterile water and saline solution for acceleration of postvasectomy azoospermia. Urol J. 2008; 5: 37-40 Google Scholar For vasectomy with vas irrigation, no conclusions can be made based on previously published studies, as those studies were of poor quality, relatively small, and therefore underpowered. 2 Cook L.A. Van Vliet H.A.A.M. Lopez L.M. Pun A. Gallo M.F. Vasectomy occlusion techniques for male sterilization. Cochrane Database Syst Rev. 2009; (article no. CD003991. 10.1002/14651858.CD003991.pub3): 37-40 Google Scholar None of the those studies mentioned about the method of semen analysis (spun vs. unspun sample) except, Mason et al 2002 used centrifuged semen sample for postvasectomy semen analysis. Editorial CommentUrologyVol. 76Issue 2PreviewSingh et al1 suggest that many men view delayed sterility as a drawback to a vasectomy, and the authors therefore recommended an intraoperative vas flush with 30 mL of sterile water as a more rapid way to clear the sperm from the abdominal vas. Based on these data, the authors advocated routine adoption of this procedure. However a vas flush is not new, and data from earlier studies have been contradictory.2 Full-Text PDF