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Open-ended vasectomy? An open question

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Elective procedures should be all about reducing pain and reducing risk. A rare but real problem is post-vasectomy pain syndrome. An open-ended vasectomy allows the testicular side of the cut vas to remain open. Imagine a pop off valve. This is the idea behind open-ended vasectomy. The epididymus, which is the series of tubes next to the testicle will not have an increase in pressure. Sperm will be recycled and broken down as it reaches the end of the line, so to speak. The other end of the vas is sealed with cautery and a suture. The other end is also pushed far away in a separate fascial sheath.

Although no head to head studies exist, this step may decrease the discomfort experienced after a vasectomy. I utilize this technique during many of my vasectomy procedures.

Obviously, there is concern over a possible increase in risk of failure. A retrospective study showed that 1 out of 200 men had to have a repeat procedure because of persistent sperm. There were no reported pregnancies in the study. (source: J Am Board Fam Pract. 1994 Jul-Aug;7(4):285-7. Open-ended vasectomy: approaching the ideal technique.) The study also showed only one case of lasting discomfort. An open-ended vasectomy is performed by many and appears to be an effective method of vasectomy.

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