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No-scalpel Vasectomies by Skilled Surgeons may Speed Recovery

and urologists — had experience with the standard vasectomy technique and three had experience with the no-scalpel method. Inexperienced surgeons received training in the no-scalpel technique.

In this study, men who received no-scalpel vasectomies had less bleeding, bruising, infection and pain during surgery and follow-up. Doctors using the no-scalpel method had more surgical difficulties than those who used the incision method — primarily locating the vas. Even so, the no-scalpel method resulted in a shorter operation. The patients also had a shorter recovery with a quicker resumption of postoperative sexual activity.

The smaller trial included 100 participants treated at a single site in Denmark. None of the eight doctors had substantial experience in the no-scalpel technique. Training was limited to an instructional video and one supervised procedure. Only one surgeon performed more than 10 no-scalpel vasectomies in the trial.

The smaller study showed no difference in postoperative results between the two techniques, but this, review authors say, could have been due to the small numbers of participants. Another important factor was the lack of experience that participating doctors had in the no-scalpel technique.

Both studies found the two techniques to be equally effective in terms of providing permanent fertility control. Although the larger study seemed to demonstrate many advantages to the no-scalpel method, the reviewers found the results inconclusive, largely because results from the studies could not be pooled for analysis.

"From the results of the review, we would agree that the no-scalpel methodology is the preferable method to use, as it has lower rate of adverse events," Cook said. "But the no-scalpel technique requires more training and a higher level of skill. One of the most important issues for men seeking a vasectomy is the experience of the surgeon with that particular method."
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