Vasectomy Techniques Could Be Improved in South and South East Asia – August 1, 2005

Research Triangle Park, NC — Research published by Family Health International, Laval University in Quebec City, Canada, and collaborators in the open-access journal BMC Urology suggests that — with more research and expanded efforts — vasectomy surgical techniques in South and South East Asia could be improved. With improved techniques, lower vasectomy failure rates would be expected.

The study, which involved interviews and observations within 21 vasectomy clinics in five Asian countries, found that no-scalpel vasectomy with simple ligation and excision of the vas deferens was the most common technique performed in the region. In the publication, principal investigator Michel Labrecque of Laval University also noted both facilitating factors and barriers to implementing facial interposition and thermal cautery, which are known to improve vasectomy effectiveness. Providers showed great interest in both techniques, but their use is rare because of lack of training; time constraints in the context of busy clinics; absence of national guidelines mandating their use; and, for thermal cautery, a lack of equipment and supplies.

Current research suggests that failure rates for cautery combined with fascial interposition are consistently lower than 1 percent, compared with about 5 percent for ligation and excision plus fascial interposition and about 10 percent for ligation and excision alone. (These estimates are based on semen analysis data rather than pregnancy rates, which are more difficult to measure.) Hand-held, battery-powered thermal cautery devices that are available and affordable in the developed world may also be feasible for use in developing countries.

"Thermal cautery combined with fascial interposition may prove to be an ideal vasectomy method," says Dr. Labrecque, "but before it can be introduced on a large scale in Asia, more studies on the safety, effectiveness, and feasibility of implementation are needed."

The data from this observation study of provider practices provide a baseline for efforts to improve vas occlusion techniques to increase vasectomy effectiveness and acceptance in the region. The study was conducted in Cambodia, Thailand, India, Nepal, and Bangladesh. Collaborators included Family Health International; Laval University; Maulana Azad Medical College in India; Chhetrapati Family Welfare Center and Nepal Fertility Care Center in Nepal; and EngenderHealth offices in Bangladesh, India, and the United States. To access the full article free of charge, click here.

Source:

Labrecque M, Pile J, Sokal D, Kaza RCM, Rahman M, Bodh SS, Bhattarai J, Bhatt GD, Vaidya TM. Vasectomy surgical techniques in South and South East Asia. BMC Urol 2005;5(1):10.

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