Vasectomy is a surgical method used in men to cut or tie the vas deferens. The vas is a tube that delivers sperm from the testicles. The purpose of vasectomy is to provide permanent birth control. Usually the operation involves cutting the skin of the scrotum with a scalpel. A newer technique uses a sharp instrument to puncture the skin instead. The intent is to have fewer problems with bleeding, bruising, and infection. This review looked at whether the no-scalpel approach to the vas worked as well as the scalpel method. It also studied any side effects of the methods and whether the men liked the method.
In October 2001, we did a computer search for studies comparing the no-scalpel approach to the vas with the scalpel method. We included randomized controlled trials in any language. For the initial review, we also looked at reference lists of articles and book chapters.
We found two trials that looked at the no-scalpel approach to the vas. The trials had somewhat different results. The larger trial showed the no-scalpel method led to less bleeding, infection, and pain during and after the procedure. The no-scalpel approach required less time for the operation and had a faster return to sexual activity. The smaller study did not show these differences. However, the study may have been too small and many men dropped out. The two methods did not differ in the numbers of men who became sterile.