Difference in the Index of Complications of Performing Vasectomy by the Conventional Technique Versus “No Scalpel” Technique. A Prospective Cohort Study

Background : Vasectomy is a quick, safe, definitive contraceptive method and is less expensive than uterine tube ligation. Nonetheless, it is noted that worldwide there is a predominance in the use of the second method. Many men link vasectomy to castration or a loss of masculinity, yet a substantial number are also anxious about the scalpel, the pain, and the discomfort involved in the procedure. In 1974, at the Chongqing Family Planning Scientific Research Institute located in China's Sichuan province, Li Shunqiang developed a new method of accessing the vas deferens without requiring scalpel incisions. The method called “no scalpel vasectomy (NSV)”, which left the blades aside, also had a smaller scar and a lower rate of complications such as infection and hematoma. Methods: In this context, we developed a prospective cohort study in which 60 randomly selected men who wished to undergo vasectomy were divided into two groups: those undergoing surgery using the conventional technique and those undergoing minimally invasive technique. The complication rates between each technique were then evaluated. The intensity of pain reported by the patients and the duration of each technique will also be compared. Results: The main complications studied were hematoma, infection and wound dehiscence. Others such as mild local discomfort, scrotal edema, need for conversion from minimally invasive to conventional technique and significant number of spermatozoa in the ejaculate after 45 days of vasectomy were described as "observed changes". There was a higher incidence of wound dehiscence and observed changes in the conventional technique. Conclusions : This study corroborates the conclusion of other more robust research that the minimally invasive/non-scalpel vasectomy technique presents fewer complications and should be recommended, despite requiring a greater learning curve.