What is your experience with the VasClip procedure, and do you have any information on if men are less likely to suffer PVPS (post-vasectomy pain syndrome) if they have the VasClip procedure done? Also, in regards to PVPS, what are the most-effective treatments?
I have completely abandoned using the VasClip for several reasons. Most importantly, it has been shown by a recent study to have a 25% failure rate, which is an unacceptably high failure rate for any form of contraception. Additionally, the device adds an additional cost of approximately $500 (USD) to the cost of the procedure which must be incurred by the patient. In the United States, most insurance carriers do not cover this additional cost. Finally, it offers no advantages over a standard vasectomy. The Vasclip is just an another method to ligate the vas deferens and to prevent sperm from traveling across it. Regardless of what the manufacturers of the device might tell us, the Vasclip DOES NOT decrease the rate of post-vasectomy pain syndrome (PVPS).
PVPS is an uncommon occurrence after a vasectomy and is related to “back pressure” on the epididymis. There is some evidence to suggest that we can prevent PVPS either by performing the vasectomy as high as possible on the vas deferens or leaving the testicular end of the vas deferens open. Leaving the testicular end of the vas deferens can lend itself to its own problems, and therefore, many urologists do not do this. I always attempt to perform vasectomy on my patients as high as possible on the vas deferens. Treatment of PVPS involves prolonged courses of anti-inflammatory medicines, warm soaks and scrotal support. In the most refractory cases a vasectomy reversal or epididymectomy (removal of the epididymis) may be required.
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