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. 2026 Feb 9:101097JU0000000000004984.
doi: 10.1097/JU.0000000000004984. Online ahead of print.

Effectiveness and Complications of Vasectomy with Fascial Interposition Without Mucosal Cautery: A Retrospective Cohort Study

Neil L Pollock  1   2 , Jack Chang  1   2 , Eliana Onishi  1 , Arthur Chatton  3   4 , Michel Labrecque  4   5
Affiliations

Effectiveness and Complications of Vasectomy with Fascial Interposition Without Mucosal Cautery: A Retrospective Cohort Study

Neil L Pollock et al. J Urol. .

Abstract

Purpose: Combining fascial interposition and mucosal cautery while leaving the testicular end open (open-ended vasectomy) is an effective and recommended vasectomy occlusion technique. We compared the effectiveness and complication risks of this technique to performing fascial interposition alone without any mucosal cautery (double open-ended).

Materials and methods: We conducted a retrospective cohort study with historical and concomitant controls using the electronic records of 5894 vasectomy patients at a private clinic in Vancouver, Canada. Two surgeons performed no-scalpel vasectomies using fascial interposition with a chromic gut suture and needle. The control group received mucosal cautery of the abdominal segment and fascial interposition covering the abdominal end, whereas the intervention group underwent fascial interposition only without any mucosal cautery. Occlusive effectiveness was assessed using the American Urological Association postvasectomy semen analysis criteria. Complications were defined as in-person visits because of vasectomy-related concerns.

Results: Occlusion successes in patients with at least 1 postvasectomy semen analysis were similar: 98.6% (2092/2122) with and 98.7% (1754/1777) without cautery (risk difference 0.1%, 95% confidence interval [CI] -0.7% to 0.9%, P = .8). There was no significant difference in overall occlusive failure between the cautery (0.8%) and no cautery (0.4%) groups (adjusted relative risk [RRadj] 0.52, 95% CI 0.20-1.22, P = .2). Complication risks were comparable: 5.3% (182/3462) with cautery and 5.2% (127/2432) without cautery (RRadj 0.95, 95% CI 0.76-1.19, P = .7).

Conclusions: Fascial interposition with sutures and needle covering of the abdominal end without mucosal cautery (double open-ended) is an effective and safe vasectomy occlusion technique.

Keywords: cautery; semen analysis; treatment outcome; vas occlusion; vasectomy.

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  • Editorial Comment.
    Theophilopoulos A, Punjani N. Theophilopoulos A, et al. J Urol. 2026 Feb 26:101097JU0000000000005006. doi: 10.1097/JU.0000000000005006. Online ahead of print. J Urol. 2026. PMID: 41747155 No abstract available.

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