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. 2019 Oct;13(3):240-244.
doi: 10.22074/ijfs.2019.5664. Epub 2019 Jul 14.

Efficacy of Intraoperative Mitomycin-C in Vasovasostomy Procedure: A Randomized Clinical Trial

Farzad Allameh  1 , Jalil Hosseini  2 , Hamidreza Qashqai  3 , Hamzeh Mazaherylaghab  4
Affiliations

Efficacy of Intraoperative Mitomycin-C in Vasovasostomy Procedure: A Randomized Clinical Trial

Farzad Allameh et al. Int J Fertil Steril. 2019 Oct.

Abstract

Background: Two-six percentage of vasectomized men will ultimately seek vasectomy reversal, which late stricture and obstruction after operation are relatively common. To find a method for improving vasovasostomy outcomes, we used intra-operative local mitomycin-C (MMC) preventing possible fibrosis and stricture.

Materials and methods: In this randomized clinical trial, 44 patients were assigned to two groups randomly during a one-year study and the data of 40 patients were analyzed. The patients were followed up for 6 months after surgery. The case group (n=19) was treated by vasovasostomy with intra-operative local MMC. The control group (n=21) underwent standard vasovasostomy.

Results: Mean sperm count in MMC group was significantly higher than the controls. The sperm count of more than 20 million/ml was respectively 53% and 14% in MMC and control groups. In a subgroup where the interval between vasectomy and reversal was 5-10 years, post-reversal azoospermia was absent in MMC group, but 50% of the controls were still azoospermic. In addition, 80% of MMC group had more than 20 million/ml sperms, but all of the controls had less than 20 million/ml sperms. No significant complication was seen.

Conclusion: Intra-operative local MMC in vasovasostomy can be regarded as a safe and efficient technique which has several advantages including lower cost. Increase of sperm count is the main effect of local MMC application that is more prominent when the interval between vasectomy and reversal is 5-10 years (Registration number: IRCT2015092324166N1).

Keywords: Clinical Trial; Mitomycin C; Sperm Count; Vasectomy Reversal; Vasovasostomy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

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Fig 1
CONSORT 2010 flow-diagram.
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