An instrument-independent no-scalpel vasectomy (IINSV) technique is reported. This technique does not use the standard specific instruments, but comparatively retains the advantages of minimally invasive instrument-dependent no-scalpel vasectomy (IDNSV). Between July 1999 and June 2002, 449 men were prospectively randomized to be vasectomized at two hospitals in Taipei. Of those who accepted, 215 underwent IDNSV at one hospital and the remaining 234 underwent IINSV at the other. The intra-operative conditions of each group were recorded. The postoperative pain and life conditions were self-reported through a questionnaire that had been carefully designed prior to the operations, in which the pain level was assessed using a 10-cm visual analogue scale under varying situations. Men vasectomized using the IINSV method experienced less operation time and postoperative complications (haematomas, infections and granulomas) (p <0.05). There were no significant differences between the two groups with respect to incision length, postoperative pain, pain at coitus, time of return to work, time of resuming intercourse, self-reported satisfaction in sexual life, postoperative psychological status, postoperative body weight change and vasectomy failure as evidenced by sperm analysis (p > 0.05 for all items). Thus, the IINSV technique can offer an alternative option for vasectomists whenever the specific instruments of standard no-scalpel vasectomy are unavailable. The IINSV technique shortens the operation time and reduces the incidence of operative complications when compared with the IDNSV technique, while still retaining the advantages of minimally invasive vasectomy.
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