We aimed to assess the occlusive effectiveness of open-ended vasectomy with mucosal cautery and fascial interposition and to determine the factors associated with occlusion failure. We studied all vasectomies performed between September 1, 2020, and August 31, 2021, by four vasectomy surgeons from Quebec City, Quebec, Canada. Sociodemographic and clinical characteristics were extracted from the electronic medical records. Occlusive effectiveness was assessed in all men with at least one postvasectomy semen analysis (PVSA). The effectiveness criteria were adapted from those of the American Urological Association (AUA) vasectomy guideline. Among the 4000 eligible vasectomies, 2242 (56.1%) were followed by at least one PVSA, with 99 (4.4%) requiring more than one PVSA. Occlusive effectiveness was achieved in 2233 vasectomies (99.6%; 95% confidence interval [CI]: 99.3%-99.8%), with 2199 (98.1%) and 34 (1.5%) classified as confirmed and probable success, respectively. The final status of the three vasectomies (0.1%) was indeterminate. Occlusive failure was observed in six vasectomies (0.3%; 95% CI: 0.1%-0.6%). The four surgeons had a similar risk of failure. The only significant factor associated with failure was the difficulty in performing the vas occlusion reported by the surgeon (7.4% [2/27] vs 0.2% [4/2212]; relative risk = 41.0; 95% CI: 7.8-214.2). The high occlusive effectiveness observed in our study validates AUA recommendations, supporting the use of this technique. Difficulty in occlusion of the vas deferens, as reported by surgeons, was the only factor associated with vasectomy failure. This finding highlights the need for PVSA in such cases.
Humans ; Male ; Vasectomy/instrumentation* ; Cautery/methods* ; Adult ; Middle Aged ; Treatment Outcome ; Semen Analysis ; Quebec

The ichnovirus TrIV, transmitted by the endoparasitic wasp Tranosema rostrale to its lepidopteran host during oviposition, replicates asymptomatically in wasp ovaries and causes physiological dysfunctions in parasitized caterpillars. The need to identify ichnoviral genes responsible for disturbances induced in lepidopteran hosts has provided the impetus for the sequencing and annotation of ichnovirus genomes, including that of TrIV. In the latter, 86 putative genes were identified, including 35 that could be assigned to recognized ichnoviral gene families. With the aim of assessing the relative importance of each TrIV gene, as inferred from its level of expression, and evaluating the accuracy of the gene predictions made during genome annotation, the present study builds on an earlier qPCR quantification of transcript abundance of TrIV rep ORFs, in both lepidopteran and wasp hosts, extending it to other gene families as well as to a sample of unassigned ORFs. We show that the majority (91%) of putative ORFs assigned to known gene families are expressed in infected larvae, while this proportion is lower (67%) for a sample taken among the remaining ORFs. Selected members of the TrV and rep gene families are shown to be transcribed in infected larvae at much higher levels than genes from any other TrIV gene family, pointing to their likely involvement in host subjugation. In wasp ovaries, the transcriptional profile is dominated by a rep gene and a member of a newly described gene family encoding secreted proteins displaying a novel cysteine motif, which we identified among previously unassigned ORFs.