Current Issue

Volume 13, Number 3, Oct-Dec 2019 Pages: 240-244

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


Farzad Allameh, M.D., M.P.H., 1, *, Jalil Hosseini, M.D, 2, Hamidreza Qashqai, M.D, 3, Hamzeh Mazaherylaghab, Ph.D, 4,
Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Men's Health and Reproductive Health Research Center (MHRHRC), Reconstructive Urology Department, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Urology Department, Imam Sajjad Hospital, Iran University of Medical Sciences, Shahriar, Iran
Faculty of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
*Corresponding Address: P.O.Box: 1666663111 Urology and Nephrology Re- search Center Shahid Beheshti University of Medical Sciences Tehran Iran Email:farzadallameh@sbmu.ac.ir

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 applica- tion that is more prominent when the interval between vasectomy and reversal is 5-10 years (Registration number: IRCT2015092324166N1).