[Vasectomy. A prospective, randomized trial of vasectomy with bilateral incision versus the Li vasectomy]. A comparative study of the no scalpel and standard incision approaches to vasectomy in 5 countries. The Male Sterilization Investigator Team.
Studies have shown that the Li vasectomy can match the effectiveness of and reduce the duration of operation and rate of complications compared to standard vasectomy with bilateral incision.
                A prospective, randomised trial was conducted to compare the Li vasectomy with the standard vasectomy with bilateral incision. Data regarding effectiveness, time of operation, the patient's pain and discomfort, and peroperative and postoperative complications were recorded. Overall, 99 patients were entered in the trial, 51 with vasectomy with bilateral incision, 48 with the Li vasectomy.
                No significant difference was found between the two methods with regard to effectiveness, time of operation, the patient's pain and discomfort, and peroperative and postoperative complications. Overall, vasectomy was inadequate in 5%, haematoma was found in 13%, infection in 9%, and scrotal pain or painful ejaculation in 9%.
                The Li vasectomy can be learned and practiced under routine conditions by residents in training with the same effectiveness and the same rate of complications as standard vasectomy with bilateral incision. The total morbidity was at the same level as in previous Danish studies, but higher than in the international studies with the Li vasectomy. We compare the safety, ease of use and effectiveness of the no scalpel and standard incision approaches to vasectomy.
                A multicenter, randomized, partially masked controlled trial was conducted at 8 sites in Brazil, Guatemala, Indonesia, Sri Lanka and Thailand. Semen samples were collected 10 weeks postoperatively and tested to ascertain sterility using verification of no living spermatozoa.
                The study included 1,429 men seeking vasectomy. The efficacy of the 2 approaches was virtually identical. In the no scalpel group operating time was significantly shorter, and complications and pain were less frequent than in the standard incision group. The no scalpel group resumed intercourse sooner, probably as a result of less pain following the procedure.
                The no scalpel approach is an important advance in the surgical approach to vasectomy, and offers fewer side effects and greater comfort compared to the standard incision technique, without compromising efficacy.
The no-scalpel approach to the vas resulted in less bleeding, hematoma, infection, and pain as well as a shorter operation time than the traditional incision technique. No difference in effectiveness was found between the two approaches.