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Open-ended vasectomy: approaching the ideal technique.

BACKGROUND: This study was conducted to determine whether the open-ended technique of vasectomy is an improvement over traditional closed-ended techniques.

METHODS: A switch from closed-ended to open-ended vasectomy was affected in 1988 at the authors' vasectomy clinic. Patients were contacted by telephone 1 to 3 years after vasectomy.

RESULTS: The authors successfully contacted 200 of 257 consecutive open-ended vasectomy patients (78 percent). Among the 200 men there were no reported pregnancies among their partners, but there was one (0.5 percent) failure of the sperm to clear, which was treated by repeat vasectomy. There were 3 (1.5 percent) mild infections, 1 (0.5 percent) sperm granuloma, and 1 (0.5 percent) case of late, intermittent pain.

CONCLUSIONS: This open-ended vasectomy series has low complication and failure rates, corroborating findings from two larger series. There is no increase in the failure rate using the open-ended technique compared with the closed-ended technique. The single case of late pain is consistent with a decrease in this complication. Open-ended vasectomy approaches the ideal vasectomy.

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