First off, all open vasectomies will eventually close. It’s what the body does with leaks. It just takes longer with an open vasectomy. Secondly, sperm are created in the body at puberty, having never been seen before and are “foreign” to the immune system. To me, this means that the potential inflammation, pain and scarring is more likely when sperm spill out of their natural habitat. It makes more sense to keep them where they normally live within the vas deferens and to not wake up the sleeping giant that is the immune system. Lastly, my patients just don’t have the same pain rates that are reported in the literature, which gives me pause when I think about changing what I do. And believe me, I am all about change if it’s for the better.
Is there any long-term upside in having an open-ended vasectomy instead of a closed vasectomy, given that all open vasectomies will eventually close?
I found https://pubmed.ncbi.nlm.nih.gov/12340687 "Open-ended vasectomy prevents pain, may enhance reversibility" but the study dates back from 1986 and seems to focus on two or three physicians.