(N�89); 145 subjects (72 ER-minocycline and 73 placebo) completedthe study. The number of ER minocycline and placebo treated subjectswith a 50% reduction in sperm concentration, 50% reduction in motilityand 20% reduction in normal morphology were similar. The mean FSHlevels in ER-minocycline and placebo treated subjects were similarexcept at 1 week. Adverse events were reported in 33 subjects (36.3%)in the ER minocycline group and 27 subjects (30.3%) in the placebogroup. Transient changes in clinical laboratory parameters in ER-minocycline treated subjects (N�3) were considered unrelated to treat-ment, however a positive ANA and increased ALT was seen in onepatient each and was possibly related to ER-minocycline.

CONCLUSIONS: The results of this study indicate that humanspermatogenesis and circulating levels of FSH and testosterone areunaffected by the administration of ER-minocycline for up to 12 weeks.

Source of Funding: Medicis Pharmaceutical Corporation

2282VASECTOMY VERSUS TUBAL OCCLUSION: A COST BASEDANALYSIS FOR SURGICAL STERILIZATION

Christopher Starks*, Stanton Honig, New Haven, CT

INTRODUCTION AND OBJECTIVES: According to NationalStudy of Family Growth, the percentage of married men reportingvasectomy versus married women reporting tubal sterilization was13.8% and 21.3% respectively. For men, vasectomy (VAS) is an officebased procedure. Permanent sterilization procedures for women in-clude operating room based laparoscopic tubal ligation (LTL), or Es-sure and Adiana hysteroscopic tubal occlusion (HTO). The objective ofour study is to determine which procedures are most cost effective forboth patients and populations.

METHODS: We performed a literature review comparing VAS,LTL, and HTO. Analysis focused on the physician reimbursement,operating room and anesthesia costs, materials, and cost of follow-uptests. For cost analysis, we utilized the average reimbursement ratefrom two local insurance carriers.

RESULTS: Table 1 shows the results comparing the variousprocedures and follow-up tests. VAS is performed with sutures orsurgical clips, and standard instrumentation. VAS requires only localanesthesia, in contrast to LTL which is done under general anesthesia.HTO may be done in the office or the operating room. LTL and HTOrequire significant instrumentation, including disposables dependingupon institution. Hysteroscopic sterilization performed in the outpatientsetting costs significantly more at $5595.72. Additionally, a hysterosal-pingogram (HSG) is required to confirm bilateral tubal occlusion afterplacing Essure and Adiana devices. The HSG, an invasive radiographicexam, is performed twelve weeks after placement and costs $355.53.By comparison, a confirmatory semen sample costs $14.14.

CONCLUSIONS: VAS is safer and requires less costly medicalequipment. Data supports that vasectomy is as effective a method ofsterilization, and we propose that VAS offers significant economicadvantages when compared to LTL or HTO. Despite higher costs, LTLis still a more common procedure. Patients, third party payers, andpopulations should advocate for male surgical sterilization as this is themost cost effective method of permanent surgical sterilization.

TABLE 1: Cost Analysis for Sterilization Procedures and Follow-up Tests

VAS LTL HTOPhysician Payment $860.66 $581.80 $4470.19

Equipment (estimate) $15.01 $173.06 $770

Facility OperatingRoom Payments none $870 optional

Operating RoomAnesthesia Payments none $174 optional

Operating RoomAnesthesia Physician Payments none $677 optional

Post VASSemen Analysis $14.14 none none

HSG x rayfee and RadiologyPhysician Payments none optional $355.53

Total $889.81 $2475.86 $5595.72

Source of Funding: None

2283A COMPARISON OF EPIDIDYMECTOMY ANDVASOVASOSTOMY FOR THE SURGICAL TREATMENT OFPOSTVASECTOMY PAIN SYNDROME

Hee Young Park, Dong Suk Min*, Seung Wook Lee, Seung HwanLee, Won Sik Ham, Kang Su Cho, Seoul, Korea, Republic of; TaeHyo Kim, Busan, Korea, Republic of; Jung Yoon Kang, Tag KeunYoo, Hong Yong Choi, Seoul, Korea, Republic of

INTRODUCTION AND OBJECTIVES: To compare the out-come of epididymectomy and vasovasostomy in patients with postva-sectomy pain syndrome (PVPS) who required surgical treatment.

METHODS: A total of 50 patients with PVPS who underwentepididymectomy or vasovasostomy between January, 2000 and Janu-ary, 2010 were included retrospectively. Of these, 36 (72.0%) patientscompleted the study questionnaire. These 36 patients either completedthe questionnaire during attendance at the outpatient clinic or during atelephone interview. 20 patients (22 cases) underwent epididymectomyand sixteen patients (17 cases) underwent vasovasostomy. Analyseswere performed for: (i) preoperative clinical findings, (ii) preoperativeand postoperative visual analogue pain scale (VAPS) scores, and(iii) patient satisfaction with surgical treatment. The latter analysis wasbased on the following 4 outcome categories: cure, marked improve-ment, no change, or recurrence (Figure 1).

RESULTS: The mean age was 48.28�11.27 years and themean period of follow-up was 3.58 years (0.15–10.03). The meanVAPS score was 6.78�0.93 preoperatively and 1.13�0.72 postopera-tively (p�0.001). The difference in the mean preoperative and postop-erative VAPS scores was 6.00�1.34 (3–8) in the epididymectomygroup and 5.50�1.03 (4–8) in the vasovasostomy group. However,this difference was not statistically significant (p�0.227) (Table 1). Nosignificant difference in satisfaction with surgical outcome was ob-served between the epididymectomy and the vasovasostomy groups(p�0.124).

CONCLUSIONS: In PVPS patients requiring surgical treat-ment, no significant difference was observed between the epididymec-tomy and vasovasostomy groups in either the reduction of pain or thedegree of patient satisfaction with surgical outcome. Selection of theoptimal surgical procedure may be dependent on specific patient char-acteristics.

Vol. 185, No. 4S, Supplement, Wednesday, May 18, 2011 THE JOURNAL OF UROLOGY� e915