No-scalpel vasectomy: a unique approach to the vas
Pollack, A.E.; Moore, C.
Ippf Medical Bulletin 27(6): 1-2
1993
ISSN/ISBN: 0019-0357 PMID: 12288623 Document Number: 411054
Dr. Li Shunqiang of the Chongqing Family Planning Scientific Research Institute in Sichuan province, China, developed the no-scalpel vasectomy (NSV) in 1974. Before NSV, few men had undergone vasectomy. Since its introduction, more than 9 million men in Sichuan province have accepted NSV. Today in Sichuan province, 5 NSVs are performed for every 1 tubal occlusion. NSV was introduced outside of China in 1985. During 1990-1992, 50,000 men received NSVs from programs supported by the Association for Voluntary Surgical Contraception (AVSC) in 19 countries. A vasal nerve block anesthetizes the area. Two instruments have been designed exclusively for NSV: the extracutaneous vas deferens ringed clamp and the vas deferens, dissecting forceps (also a modified hemostat). Surgeons should undergo hands-on training in the NSV technique, especially since they need to be able to identify the vas through the scrotal skin and subdermal fat. AVSC provides assistance to NSV training programs in 30 countries outside of North America. AVSC's publication No-Scalpel Vasectomy: An Illustrated Guide for Surgeons is a great resource for NSV workshops and hands-on training. Surgeons puncture the scrotal skin to deliver the vas. No stitches are required. They can cover the puncture with an adhesive dressing or a sterile gauze dressing. A scrotal support should be worn for a few days. Sexual intercourse with temporary contraceptive protection can resume within 2-3 days. The recently vasectomized man should provide a semen sample for sperm analysis either 12 weeks after the operation or after 20 ejaculations. NSV takes less time to do and causes fewer complications than dos the traditional incisional technique. For example, during the King's birthday vasectomy festival in Thailand, men undergoing traditional vasectomy had an immediate complication rate of 3.1% compared to 0.4% for those undergoing NSV. Since it is also less invasive than the traditional technique, it is more acceptable to men.