Vas occlusion by tantalum clips and its comparison with conventional vasectomy in man: reliability, reversibility, and complications.

Occlusion of the vas deferens has been carried out by applying tantalum clips in 60 men. Another 50 men were vasectomized conventionally and served as controls. Vasography showed that two clips were required on each vas to bring about perfect and firm occlusion. The incidence of postoperative infection and other complications was much lower in the clip-occluded cases. Under a long-term follow-up, 10% of the conventionally vasectomized men were dissatisfied with the operation as compared with 2% of the clip-occluded group. Both groups became azoospermic within 3 months and the failure rate was zero. Removal of the clips not only was difficult but left the vas compressed and leaking. The method cannot, therefore, be considered reversible by itself. However, recanalization could easily be achieved by end-to-end anastomosis after excision of the small clipped segment or by side-to-side anastomosis without any excision. This, damage to the neuromuscular apparatus of the vas may be minimized. Male sterilization by clip occlusion has the advantages of minimal surgical intervention, shorter operative time, safety from postoperative infection, and easier recanalization if desired.