Question
Which method of vasectomy has the highest failure rate?
| A. |
Open-ended vasectomy with granulation formation
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| B. |
Cutting and ligating vas to occlude the proximal and distal lumen
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| C. |
Use of hemoclips with 1–4 cm gap after cutting proximal and distal ends
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| D. |
Cutting the vas and turning the ends backwards and ligating with suture material
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Show Answer
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Correct Answer » B
Explanation
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The simple ligation and excision technique has a relatively higher failure rate because recanalization can occur between the divided ends of the vas deferens.
The effectiveness of vasectomy depends on creating a reliable and permanent separation/occlusion of the vas. Techniques that provide greater separation or additional methods of occlusion reduce the likelihood of recanalization.
The provided study material confirms that surgical failure is an important cause of failed vasectomy and that the overall vasectomy failure rate is very low (approximately 0.15–0.2 per 100 woman-years).
Why the other options are less likely
- A. Open-ended vasectomy with granulation formation — Incorrect
- The testis-facing end is left open, allowing sperm to drain into the surrounding tissue and form a granuloma.
- This technique can provide effective contraception, although it is designed differently from simple ligation.
- C. Hemoclips with a 1–4 cm gap — Incorrect
- Creating a gap between the divided ends reduces the possibility of spontaneous reconnection.
- D. Turning the cut ends backward and ligating — Incorrect
- This provides additional mechanical separation of the vas ends and decreases the likelihood of recanalization.
