https://doi.org/10.4081/aiua.2024.12682

Vasectomy histology: Is it still useful?

Vol. 96 No. 3 (2024)
Submitted: May 21, 2024
Accepted: June 13, 2024
Published: October 2, 2024
Vasectomy, Semen analysis, PVSA, Sterility, Patient compliance, histopathology
Abstract Views: 113
PDF: 49
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Authors

Anthony Sim
https://orcid.org/0009-0009-4346-8475
Imperial College London, United Kingdom.
Panagiotis Nikolinakos
https://orcid.org/0000-0001-8427-7223
Department of Surgery, West Middlesex Hospital, Isleworth, London, United Kingdom.
Konstantinos Charitopoulos
https://orcid.org/0000-0001-9282-4549
Department of Surgery, West Middlesex Hospital, Isleworth, London, United Kingdom.
Ivo Donkov
Department of Surgery, West Middlesex Hospital, Isleworth, London, United Kingdom.
Samuel Bishara
bishsam@googlemail.com
Department of Surgery, West Middlesex Hospital, Isleworth, London, United Kingdom.

Objectives: To determine if histological evaluation of the vasa is useful when post-vasectomy semen analysis (PVSA) compliance is low and to determine whether compliance could be predicted.
Methods: A retrospective evaluation of patients undergoing vasectomy between 2018 and 2022 was undertaken. A comparison of the PVSA between three vasa histological categorisations was made: complete divisions, incomplete division(s), absent vas(a). A multivariate model was constructed to predict PVSA compliance.
Results: From 388 patients, 191 (49.2%) undertook PVSA. Four patients had a revision of vasectomy. On 3 occasions this was due to the histology findings and once from semen analysis with normal histology. There was no significant difference in the number of azoospermic samples (95.4% vs 91.2%, ns), of samples with presence of Rare Non-Motile Sperm (RNMS) (2.6% vs 8.8%, ns) and those with sperm present (2.0 vs 0%, ns), between patients with complete division of the vasa on both sides and those with incomplete division on one side respectively. There was no difference in patient characteristics between those who complied with PVSA and those who did not.
Conclusions: This paper suggests that there is a role for histological evaluation of the vasa when PVSA compliance is poor. Incompletely divided vasa on histology are not associated with an adverse PVSA.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
NHS England. Part 4: Sterilisations and vasectomies. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/sexual-and-reproductive-health-services/2021-22/sterilisations-and-vasectomies
Haldar N, Cranston D, Turner E, et al. How reliable is a vasectomy? Long-term follow-up of vasectomised men. Lancet. 2000;356:43–4.
Hancock P, Woodward BJ, Muneer A, Brown JCK. 2016 Laboratory guidelines for postvasectomy semen analysis: Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons. J Clin Pathol. 2016;69:655–60.
Beder D, Chitale S. The clinical impact of British guidelines on post-vasectomy semen analysis. Cent European J Urol. 2020;73:558-562.
Agarwal A, Gupta S, Sharma RK, et al. Post-Vasectomy semen analysis: optimizing laboratory procedures and test interpretation through a clinical audit and global survey of practices. World J Mens Health. 2022;40:425–41.
Sharlip ID, Belker AM, Honig S, et al. Vasectomy: AUA guideline. J Urol. 2012; 188: 2482.
FSRH. Clinical Guideline: Male and Female Sterilisation (September 2014). Available from: https://www.fsrh.org/standards-and-guidance/documents/cec-ceu-guidance-sterilisation-cpd-sep-2014/
Katsoulis IE, Walker SR. Vasectomy management in Morecambe Bay NHS Trust. Ann R Coll Surg Engl. 2005;87:131.
Miller S, Couture S, James G, et al. Unilateral absence of vas deferens: prevalence among 23,013 men seeking vasectomy. Int Braz J Urol 2016;42:1010–7.
Carr R. Apparent bilateral duplication of the vas deferens. Br J Urol. 1993;71:354.
Erdemir F, Parlaktas BS, Yasar A, Uluocak N. Duplicated vas deferens: A rare congenital abnormality. Kaohsiung J Med Sci. 2008;24:210–1.
Karaisli S, Ezer M. Duplicated vas deferens: A case report and comprehensive review of the literature. Andrologia. 2021;53:e13896.
Christensen RE, Maples DC. Postvasectomy semen analysis: are men following up? J Am Board Fam Pract. 2005;18:44–7.
Bradshaw A, Owusu R, Ballon-Landa E, et al. Poor compliance with post-vasectomy semen analysis: analysis of factors and barriers. J Urol. 2019;201:e685.
Diederichs J, McMahon P, Tomas J, Muller AJ. Reasons for not completing postvasectomy semen analysis. Available from: https://www.cfp.ca/content/cfp/65/9/e391.full.pdf
Maatman TJ, Aldrin L, George BGS, Car-Others G. Patient noncompliance after vasectomy. Fertil Steril. 1997;68:552-5.
Derosa R, Lustik MB, Stackhouse DA, McMann LP. Impact of the 2012 American urological association vasectomy guidelines on postvasectomy outcomes in a military population. Urology. 2015;85:505-10.
Philp T, Guillebaud J, Budd D. Late failure of vasectomy after two documented analyses showing azoospermic semen. Br Med J. 1984;289:77.
Kiessling RJ, Hauser A, Eyre RC, Kiessling AA. A new approach to postvasectomy semen analyses eliminates the need to evaluate a fresh specimen. Andrology. 2023;11:464–70.
Welliver C, Zipkin J, Lin B, et al. Factors affecting post-vasectomy semen analysis compliance in home- and lab-based testing. Can Urol Assoc J. 2023;17:E189-92.
Trussler J, Browne B, Merino M, et al. Post-vasectomy semen analysis compliance with use of a home-based test. Can J Urol 2020;27:10388–93.
Atkinson M, James G, Bond K, et al.. Comparison of postal and non-postal post-vasectomy semen sample submission strategies on compliance and failures: an 11-year analysis of the audit database of the Association of Surgeons in Primary Care of the UK. BMJ Sex Reprod Health. 2022;48:54–9.
Blazek AJ, Belle JD, Deibert MP, Deibert CM. Legal review of vasectomy litigation and the variables impacting trial outcomes. Urology. 2019;131:120–4.

How to Cite

Sim, A., Nikolinakos, P., Charitopoulos, K., Donkov, I., & Bishara, S. (2024). Vasectomy histology: Is it still useful?. Archivio Italiano Di Urologia E Andrologia, 96(3). https://doi.org/10.4081/aiua.2024.12682
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