Munro Nicholas P, Kotwal Sanjeev, Gogoi Ng K, Weston Philip M T, Browning Anthony J, Harrison Simon C W, Biyani Shekhar, Chahal Rohit, Sundaram Subramanian K
Mid Yorks NHS Trust, Pinderfields General Hospital, Wakefield, Leeds, UK.
BJU Int. 2009 Aug;104(3):371-5. doi: 10.1111/j.1464-410X.2009.08416.x. Epub 2009 Feb 23.
To assess the effect of adding lumen diathermy fulguration to our standard technique of vas ligation with polyglactin 910 (Vicryl(TM), Ethicon, Sommerville, NJ, USA) excision and fascial interposition, in an attempt to improve our sterilization rates. We previously reported the effect of changing suture material on vasectomy success rates; 3005 post-vasectomy semen analyses (PVSA) revealed a decrease in sterilization rates after surgery on changing from chromic catgut to polyglactin 910.
We retrospectively reviewed PVSA undertaken for vasectomies performed by urological surgeons at the Mid-Yorkshire NHS Trust for 18 months from September 2005 to February 2007.
There were 592 vasectomies in all; the age distribution of patients between the groups treated with the standard and new method was similar. Overall, 166 patients (28%) failed to provide two semen samples as instructed, and so were excluded from further analyses. Sterility was achieved in 367 patients (86%); a further 28 (7%) have indeterminate analyses to date, with one of the last two PVSAs showing sperm, with the PVSA of 32 (7%) patients showing persisting sperm. For the eight surgeons reviewed the sterility rates were broadly similar.
The introduction of diathermy fulguration of the lumen has not improved vasectomy sterilization rates, with up to 14% having sperm on PVSA.
评估在我们使用聚乙醇酸910（薇乔™，美国新泽西州萨默维尔市Ethicon公司）切除和筋膜间置法进行输精管结扎的标准技术中增加管腔透热电灼术，以提高绝育率。我们之前报道了更换缝合材料对输精管切除术成功率的影响；3005例输精管切除术后精液分析（PVSA）显示，从铬制肠线更换为聚乙醇酸910后，术后绝育率有所下降。
我们回顾性分析了2005年9月至2007年2月期间，在北约克郡国民保健服务信托基金接受泌尿外科医生进行输精管切除术的患者的PVSA。
总共进行了592例输精管切除术；采用标准方法和新方法治疗的两组患者年龄分布相似。总体而言，166例患者（28%）未按要求提供两份精液样本，因此被排除在进一步分析之外。367例患者（86%）实现了绝育；另有28例（7%）患者的分析结果至今仍不确定，其中最后两次PVSA中的一次显示有精子，32例（7%）患者的PVSA显示有持续精子。对于所评估的八位外科医生，绝育率大致相似。
引入管腔透热电灼术并未提高输精管切除术的绝育率，高达14%的患者PVSA显示有精子。
