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 ::  Abstract
 ::  Introduction
 ::  Material and Methods
 ::  Results
 ::  Discussion
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 ::  References
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ARTICLE
Year : 1978  |  Volume : 24  |  Issue : 4  |  Page : 218-220

Immediate sterility after vasectomy with the use of 0.1% ethacridine lactate


Departments of Obstetrics & Gynaecology and Surgery, B.J. Medical College and Sassoon General Hospitals, Poona 1., India

Correspondence Address:
D S Kamat
Departments of Obstetrics & Gynaecology and Surgery, B.J. Medical College and Sassoon General Hospitals, Poona 1.
India
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PMID: 745150

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 :: Abstract 

Irrigation of the vas with 0.1% ethacridine during vasectomy flushes the sperms and causes lysis from the distal genital tract, without any serious complication or side effect. In the light of this experience, it is suggested that this method can be used in all vasec­tomy operations carried out for primary sterilisation so as to pro­duce immediate sterility.



How to cite this article:
Kamat D S, Bharucha E K, Sankholkar P C. Immediate sterility after vasectomy with the use of 0.1% ethacridine lactate. J Postgrad Med 1978;24:218-20

How to cite this URL:
Kamat D S, Bharucha E K, Sankholkar P C. Immediate sterility after vasectomy with the use of 0.1% ethacridine lactate. J Postgrad Med [serial online] 1978 [cited 2014 Oct 23];24:218-20. Available from: http://www.jpgmonline.com/text.asp?1978/24/4/218/42650



 :: Introduction Top


It takes several weeks for the semen to be sperm-free after vasectomy. A world wide search is going on for an effective non-toxic chemical agent which can be injected into the distal segment of the vas at the time of vasectomy so as to produce immediate sterility by washing out and destroying the residual sperms in the distal genital tract.

Von Friesen [4] described a method it which 0.1% ethacridine was used. He claimed that ethacridine kills the spermatozoa in the vas deferens and seminal vesicles.

Craft and McQueen [1] described a significant success over plain vasectomy by using "sterile water".

Similarly Urquhard-Hay [3] has described his success by using 0.1% Euflavin.

In our preliminary study [2] on dogs and human spermatozoa with ethacridine lactate, it was noted that ethacridine was safe for this purpose.


 :: Material and Methods Top


Vasectomy for the purpose of con­traception was carried out in 43 patients in Sassoon General Hospital, Poona, on an outpatient basis using local anaes­thesia. Each vas was exteriorized through a separate scrotal incision 1 cm long and divided; the two ends were separated and ligated.

The selection of cases for control and irrigation was done on randomized basis. In controls, only vasectomy was done without irrigation. In the irrigated group, the distal end of each vas was cannulated with a blunt-ended 24 num­ber needle attached to a 5 ml syringe containing a sterile solution of 0.1% ethacridine lactate; 2.5 ml of the solution was injected slowly down each vas be­fore the ligation of both the proximal and the distal ends.

The skin incision was closed by apply­ing Halax spray dressing. Benzathine penicillin was given to all these cases.

Each patient was reviewed at one week, one month and three months after the procedure. Examination of semen was carried out during this follow up visits. Specimens were collected by masturbation and examined immediately.


 :: Results Top


The subjects were in the 24-44 year age group. All had more than two living children.

During irrigation of the vas with ethacridine solution, all patients experi­enced a sensation in the posterior urethra which most of them have descr.bed as a desire to void.

The urine was yellowish in all cases for 24 hours after surgery. None of the patients had pain, dysuria, frequency or haematuria in the post-operative period.

Semen examination following vasectomy

[Table 1] shows the gross difference in the results of semen examination follow­ing vasectomy between the two groups The treated patients were azoospermic at all times tested.

Pus cells were present in all the speci­mens examined at different intervals, but the average number decreased with sub­sequent time intervals. The mean num­ber of pus cells present in the irrigated group at the end of one week seems to be more than in the control group.

R.B.C.s (4-5/HPF) were present in one case from the control group; on the other hand they were present in 5 cases from the irrigated group at the end of one week. No R.B.C.s were detected at one month and three month interval specimens from both the groups.


 :: Discussion Top


Persistence of sperms, in the semen after vasectomy is wellknown. Medico­legally, two azoospermic specimens of semen 2 to 3 months after operation should be obtained before labelling the subject as sterile.

We routinely advise the use of condoms for a minimum period of 3 months after vasectomy. Many patients ignore this advice. Eight pregnancies were termi­nated in the Sassoon General Hospitals, Poona within a period of one year, for conception occurring after vasectomy operation. In all these cases, either ignorance or accidental rupture of the condom was the likely cause.

Ethacridine lactate (0.1%) is bacteri­ostatic as well as disinfectant. In our preliminary study on dog and human spermatozoa ethacridine lactate was ob­served to be a safe and effective sper­micidal drug for inducing immediate sterility after vasectomy. [2] It causes instant immobilization and lysis of sper­matozoa if used in 0.1% concentration.

The present study proves the safety and efficacy of ethacridine lactate for irrigation of the vas at the time of vasec­tomy. The presence of pus cells and R.B.C.s at one week specimen may be due to mild local irritation in the distal genital tract.


 :: Acknowledgements Top


We are thankful to the Director of Medical Education and Research, Bom­bay and the Dean, B. J. Medical College, Poona for permitting us to conduct this experiment.

Our thanks are also due to Dr. U. D. Sutaria and Dr. S. P. Dani for their guidance and help.

 
 :: References Top

1.Craft, 1. and McQueen, J.: Effect of irriga­tion of the vas on post-vasectomy semen counts. Lancet, is 515-516, 1972.  Back to cited text no. 1    
2.Kamat, D. S. and Bharucha, E. K.: Effect of 01% ethacridine lactate on the vas deferens and human spermatozoa. J. Postgrad. Med. 24: .-14-217, 1578.  Back to cited text no. 2    
3.Urquhart-Hay, D.: Immediate sterility after vasectomy. Brit. Med J., 3: 378-379, 1973.  Back to cited text no. 3    
4.von Friesen, B.: Sterility after vasectomy. Lancet, is 598-599, 1971.  Back to cited text no. 4    



 
 
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