Vasalgel™: A Future New alternative to Vasectomy and Vasectomy Reversal, or is it?

Vasectomy is a procedure with a durable track record of being a minimally invasive and reliable method of achieving permanent male contraception.   Millions of vasectomies have been performed worldwide.  the procedure can be performed in the office under local anesthesia and is generally covered by insurance.

Despite the permanence of vasectomy, Vasectomy reversal techniques have been developed which can surgically re-establish the pathway from testis to ejaculate.  These are microsurgical techniques which usually require hours to perform, but can be accomplished on an outpatient basis.  

Men’s anxiety about both of these procedures has led to efforts to develop alternatives.   Recently a male contraceptive pill was developed which  does suppress sperm production, but with the trade off of significant side effects.  

Now the makers of Vasalgel™, a product in development for years, are hoping to offer a substitute for both vasectomy and vasectomy reversal.   In the January 2017 issue of Basic and Clinical Andrology Journal officiel de la Société d’andrologie, authors Colagross-Schouten et al, report on “The contraceptive efficacy of intravas injection of Vasalgel™ for adult male rhesus monkeys”.  

What is Vasalgel™?

 The concept with Vasalgel™ is injection of a polymer substance into the vas to block it off.  No surgery, no cutting, just an injection.  And then, if restoration of fertility is desired, to simply “flush” out the gel.   In this study Vasalgel™ was placed into 16 rhesus monkeys.     Exposure of those monkeys to potential mates failed to result in any pregnancies.  

But does Vasalgel™ deliver on its goals?  In this study, the monkeys had the procedure performed under general anesthesia.   An opening in the scrotum was made and the vasa were isolated for injection.    The procedure took several minutes to accomplish on both sides.   Therefore, Vasalgel™ insertion seems to be a similar procedure to a vasectomy except that instead of dividing the vas, the gel is injected.    Three of the animals require repeat surgical procedures requiring vasectomy for reasons of incorrect placement of the Vasalgel™, persistent  wound opening  due to sperm granuloma and for an inflammatory process along the vas.   The idea of flushing the Vasalgel™ out to restore fertility was not tested.

The concept behind Vasalgel™ is appealing; however, from the perspective of this author, at this point in time, it appears more to be a modification of vasectomy, rather than a breakthrough procedure.    I, as well as the rest of the urological and medical community await the results of future Vasalgel™ studies.

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