JHPIEGO TrainerNews™ |
Clinical Update: Additional Vasectomy Techniques
Recommended
(November 2001)
Preliminary results from a vasectomy study conducted in seven countries by Family Health International (FHI) and EngenderHealth show conclusively that a surgical technique known as fascial interposition (i.e., placing a fascial barrier between the two cut ends of the vas when performing a simple ligation and excision) leads to a more rapid decrease in sperm counts, which may improve the effectiveness of some methods of vasectomy for male sterilization.
According to David C. Sokal, MD, Associate Medical Director at FHI, this new study indicates that "physicians who are currently practicing simple ligation and excision [for vasectomies] should strongly consider modifying their technique to include fascial interposition." JHPIEGO President Noel McIntosh, MD, points out that JHPIEGO learning materials already recommend fascial interposition. The most recent version of the no?scalpel vasectomy (NSV) manual for Nepal, for example, instructs the physician to "create a fascial barrier by pulling the sheath over one of the vas ends and secure it with a suture." By contrast, the AVSC/EngenderHealth NSV manual (second edition, 1997) states that a "...fascial barrier may be created by pulling the sheath over one of the vas ends." According to Dr. McIntosh, these are the two principal manuals used for vasectomy training in developing countries.
Additional background information on vasectomy methods and current research on vasectomy effectiveness is available at: http://www.engenderhealth.org/news/newsreleases/010914.html