The Influence of Suture Type on Postoperative Outcomes in Minimally Invasive Vasectomy

This study compares vasectomy outcomes between Chromic Gut and Monocryl sutures used for fascial interposition in a large cohort of patients undergoing minimally invasive vasectomy. Current guidelines do not recommend a specific suture material for fascial interposition; therefore, this study aims to evaluate two commonly used sutures to help inform surgical practice.

This retrospective study evaluated 1389 patients who underwent vasectomy by a single surgeon between March 2011 and October 2022. Patients were stratified based on suture type used for fascial interposition: Chromic Gut or Monocryl. The primary outcome was vasectomy failure, defined as the presence of live sperm or >100,000 non-motile sperm/mL on post-vasectomy semen analysis (PVSA). Secondary outcomes included postoperative pain, symptomatic sperm granuloma formation, repeat procedures, and post-vasectomy pain syndrome.

Of the 1389 included patients, Chromic Gut was used in 1145 and Monocryl in 244. There were six confirmed failures (0.61%), with no significant difference in failure rate between suture types (p = 1.0). A higher rate of postoperative pain-related follow-up was observed in the Chromic Gut group compared with the Monocryl group (p = 0.045). Additionally, the rate of sperm granuloma and follow-up procedures were higher in the Chromic group, but without statistical significance.

This large single surgeon series found no statistically significant difference in vasectomy success between Chromic Gut and Monocryl sutures for fascial interposition. However, an increase in postoperative pain-related follow-up was associated with the use of Chromic Gut. Both materials were associated with low failure rates, consistent with published data.