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

2% to 6% of vasectomized men will ultimately seek vasectomy reversal and late stricture and obstruction after operation are relatively common. To find a method for improving of vasovasostomy outcomes, we used intra-operative local mitomycin-C to prevent possible fibrosis and stricture. Design, setting, and participants: 44 patients in our referral center were assigned to two groups randomly during a one year study and data of 40 patients were analyzed. The patients were followed for 6 months after surgery.
Intervention: The case group (n=19) was treated by vasovasostomy with intra-operative local mitomycin-C. The control group (n=21) was underwent standard vasovasostomy. Mean sperm count in mitomycin-C group was significantly higher than the controls, and sperm count more than 20 million/ml in mitomycin-C and control group was 53% and 14%, respectively. In a subgroup where the interval between vasectomy and reversal was 5 to 10 years post reversal azoospermia was absent in mitomycin-C group, but 50% of controls were still azoospermic. Also, 80% of mitomycin-C 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. Intra-operative local mitomycin-C in vasovasostomy can be regarded as a safe and efficient technique which has several advantages including lower cost. Increasing of sperm count is the main effect of local mitomycin-C application that is more prominent when the interval between vasectomy and reversal is 5 to 10 years