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Abstract

Volume 12, Issue 3 (May 2010) 12, 315–321; 10.1038/aja.2009.94

Vasectomy by epithelial curettage without suture or cautery: a pilot study in humans

John K. Amory1, John W. Jessen2, Charles Muller3, Richard E. Berger3

1 Department of Medicine, Center for Research in Reproduction and Contraception, University of Washington School of Medicine, Seattle, WA 98195, USA
2 Private Practice Dentistry, Seattle, WA 98195, USA
3 Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA

Correspondence: Prof. John K. Amory,jamory@u.washington.edu

Received 4 November 2009; Revised 25 November 2009; Accepted 25 December 2009; Published online 15 February 2010.

Abstract

Curettage of the epithelium of the vas deferens might be a safe and effective method of male sterilization. We conducted a pilot study of vasectomy by epithelial curettage with a novel microcurette called the Vas-X in 12 normal men requesting elective sterilization. Seminal fluid analysis was obtained monthly after the procedure for 6 months. Pain was assessed by questionnaire. Three months after the procedure, all men attained sperm concentrations of less than 0.2 million sperm per mL, and seven were azoospermic. Post-procedural pain was minimal. Nine men ultimately achieved and maintained azoospermia; however, 4 to 6 months after the procedure, sperm concentrations increased in three of the 12 subjects, necessitating repeat vasectomy. Microscopic examination of the vas deferens from these failures revealed re-canalization. Vasectomy by epithelial curettage can result in effective sterilization; however, 1/4 of the subjects were not effectively sterilized by the procedure due to re-canalization of the vas deferens. Epithelial curettage will require further refinement to determine if it is a viable form of vasectomy.

Keywords: male contraception; male sterilization; re-canalization; spermatogenesis; vas deferens; vasectomy failure

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