AFRO-NETS> Additional Vasectomy Techniques Recommended

[David Hock <DHock@fhi.org>]

Additional Vasectomy Techniques Recommended
-------------------------------------------

Greetings and apologies for any cross-postings!

Preliminary results from a vasectomy study in seven countries show 
conclusively that a surgical technique known as fascial interposition 
leads to a more rapid decrease in sperm counts, which may improve the 
effectiveness of some methods of vasectomy for male sterilization. 
The lower sperm counts occurred when fascial interposition was used 
with simple ligation and excision. The study was conducted by Family 
Health International (FHI), based in Research Triangle Park, NC, and 
EngenderHealth, based in New York, NY. Details of the study will be 
presented at the annual meeting of the Association of Reproductive 
Health Professionals (ARHP), originally scheduled for September 12-
15, but now postponed to December 12-15, 2001. For background infor-
mation on vasectomy methods and current research on vasectomy effec-
tiveness, click here: 

http://www.fhi.org/en/fp/fpother/conferences/vascet/vasectomymtg.html 
http://www.fhi.org/en/fp/fpother/conferences/vascet/vasectomymtg.html

"Individuals all over the globe want and rely on permanent methods of 
contraception, making male and female sterilization the number one 
family planning method in the world," maintains Amy E. Pollack, M.D., 
M.P.H., President of Engender Health. "Therefore it is crucial that 
we perfect the delivery of vasectomy services, as vasectomy is the 
only permanent method available to men."

"This new study indicates that physicians providing vasectomy ser-
vices should consider modifying their technique," reports David C. 
Sokal, M.D., Associate Medical Director at FHI. "Physicians who are 
currently practicing simple ligation and excision should strongly 
consider modifying their technique to include fascial interposition."

During the study, when fascial interposition was used along with 
ligation and excision of the vas, about 93 percent of men had reached 
a low sperm count (less than 100,000 sperm per millilitre of semen) 
by 22 weeks after surgery, compared to 81 percent of men without fas-
cial interposition. Men who have not undergone vasectomy typically 
have between 20 million and 150 million sperm per millilitre of se-
men.

Family planning handbooks typically describe vasectomy as nearly per-
fect, better than 99 percent effective at preventing pregnancy. How-
ever, different ways of performing a vasectomy may result in slightly 
different pregnancy rates. This study did not look at pregnancy 
rates, but it is likely that the risk of pregnancy would be higher 
among women whose partners take longer to reach a low sperm count. It 
is estimated that only about 10 percent of vasectomies in the United 
States are done using simple ligation and excision, but that this 
method is much more commonly used in developing countries.

Some experts believe that cautery (burning the vas) may be the most 
effective vasectomy occlusion technique, with or without fascial in-
terposition. However, using cautery requires special equipment which 
might not be practical in low-resource settings. FHI and Engender-
Health are currently planning studies to evaluate cautery techniques 
for use in low-resource settings.

Various vasectomy methods and recent research on vasectomy effective-
ness were discussed at a meeting of experts, co-sponsored by Family 
Health International and Engender Health, April 18-19, 2001 in Dur-
ham, NC. A summary of the meeting can be found at the URL:
http://www.fhi.org/en/fp/fpother/conferences/vascet/vasectomymtg.html 
http://www.fhi.org/en/fp/fpother/conferences/vascet/vasectomymtg.html 

Beth Robinson, 
Associate Director for Information Programs, 
Family Health International 
mailto:brobinson@fhi.org 
Tel: +1-919-405-1461

Carrie Svingen, 
Communications Manager, 
EngenderHealth 
mailto:csvingen@engenderhealth 
Tele: +1-212-561-8538


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