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

无缝合非灼烧式输精管上皮刮除术：人类实验性研究

作　　者：John K. Amory John W. Jessen Charles Muller Richard E. Berger 

机构地区：[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

出　　处：《Asian Journal of Andrology》2010年第3期315-321,I0008,共8页亚洲男性学杂志（英文版）

摘　　要：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.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.

关 键 词：male contraception male sterilization re-canalization SPERMATOGENESIS vas deferens vasectomy failure 

分 类 号：R[医药卫生]