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No-scalpel vasectomies by skilled surgeons may speed recovery

Although no-scalpel vasectomies are becoming more popular among physicians and patients, there are no definitive statistics to confirm the superiority of this choice, and a new review's main conclusion is to underline the importance of training.

Yet training is not always available or sought, said lead reviewer Dr. Lynley Cook, a public health physician and clinical senior lecturer at the University of Otago in Christchurch, New Zealand.

She said, "Training may not be available in all places in the world and surgeons who learned how to do vasectomies using the standard incision method may not be interested in learning a new technique."

Vasectomy, a surgical form of birth control in which a duct known as the vas is cut or tied, has traditionally been performed by making an incision in the skin of the scrotum. Cutting or tying the vas, which carries sperm from the testicles, leaves a man infertile.

Instead of making an incision, the no-scalpel technique uses a sharp instrument to puncture the skin. Advantages of puncturing rather than cutting the skin of the scrotum include less bleeding, bruising, infection and pain. Also, the puncture is usually so small that it does not require stitches.

The review looked at two studies that compared the no-scalpel method of vasectomy to the traditional method. The studies arrived at conflicting results.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

The larger study, conducted in 1999, included 1,429 men in five countries: Brazil, Guatemala, Indonesia, Sri Lanka and Thailand. All eight physicians ?general surgeons and urologists ?had experience with the standard vas
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Source:Center for the Advancement of Health


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