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I Am Considering A Vasectomy, And According To The Medical
I am considering a vasectomy, and according to the medical literature (see links to citations below), the recommended methods for vas occlusion are cautery and/or fascial interposition (preferably both methods).
However, I have consulted with two local urologists, and neither of them use either of these techniques. Instead, both simply do an excision and ligation, and one of them takes an additional step of folding back and suturing the ends of the vas deferens. Both physicians have very good credentials and are highly experienced.
Is it unusual for urologists (in the U.S.) to perform only excision and ligation without any cautery or fascial interposition, or is excision and ligation still commonplace and considered good practice? Is it important to perform cautery and/or fascial interposition, and should I therefore continue to look for a urologist who performs one or both of those techniques?
Note, I am particularly concerned about long-term recanalization (i.e., a year or more after the procedure). I know the rates of late recanalization are generally assumed to be low, but as I understand it, the true rate is difficult to ascertain due to a lack of systematic long-term follow-up.
Citations:
http://onlinelibrary.wiley.com/doi/10.1002/0000.CD003991.pub4/full
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC529470/
https://www.rcog.org.uk/globalassets/documents/guidelines/nebsterilisationfull060607.pdf
https://openaccess.leidenuniv.nl/bitstream/handle/1887/4964/01.pdf?sequence=11
However, I have consulted with two local urologists, and neither of them use either of these techniques. Instead, both simply do an excision and ligation, and one of them takes an additional step of folding back and suturing the ends of the vas deferens. Both physicians have very good credentials and are highly experienced.
Is it unusual for urologists (in the U.S.) to perform only excision and ligation without any cautery or fascial interposition, or is excision and ligation still commonplace and considered good practice? Is it important to perform cautery and/or fascial interposition, and should I therefore continue to look for a urologist who performs one or both of those techniques?
Note, I am particularly concerned about long-term recanalization (i.e., a year or more after the procedure). I know the rates of late recanalization are generally assumed to be low, but as I understand it, the true rate is difficult to ascertain due to a lack of systematic long-term follow-up.
Citations:
http://onlinelibrary.wiley.com/doi/10.1002/0000.CD003991.pub4/full
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC529470/
https://www.rcog.org.uk/globalassets/documents/guidelines/nebsterilisationfull060607.pdf
https://openaccess.leidenuniv.nl/bitstream/handle/1887/4964/01.pdf?sequence=11
