ABSTRACT
PIP: No-scalpel vasectomy was developed by Dr. Li Shunkiang in China in 1974. In 1989 Profamilia carried out 18 tubal ligations for every vasectomy procedure, and this year in Bogota the first group of Profamilia surgeons underwent training in no-scalpel vasectomy. By 1995 the ratio of tubal ligations to vasectomy dropped to 10 to 1 at the national level and to 4 to 1 in Bogota. The evaluation of no-scalpel vasectomy procedures was conducted at the Men's Clinic in Bogota covering the period of 1989-94. 7513 procedures were done by 5 trained surgeons during this period. The expected incidence of complications was 3%. A sample of 2257 was obtained for evaluation. Variations in the management of the vas deferens included: 1) 1898 cases of ligation with silk and the interposition of the fascia; 2) 227 cases of monopolar electrocoagulation and interposition of the fascia; 3) 21 cases of monopolar electrocoagulation without interposition of the fascia; 4) 9 cases of ligation with silk without interposition of the fascia; and 5) 15 other cases with some kind of technical difficulty. There were no significant differences with respect to the distinct variants. The major complications were: 1) 0.3% had hematoma, 2 cases required surgical drainage; 2) 0.26% had infection, 2 cases required surgical drainage and intravenous antibiotics for scrotal abscess; 3) 1.14% had epididymitis, a congestive type that responded well to anti-inflammatory drugs, while in some cases tetracycline was needed; 4) 0.22% had vasocutaneous fistula, which were resected without problems; and 5) 0.30% had other complications including granulomas of the cord or the scrotal wall. Only 1.27% patients had to see a doctor for postoperative pain.^ieng
