A Cochrane review [Abstract] 1 included 2 studies with a total of 1529 subjects. The larger trial (n=1429) demonstrated less perioperative bleeding (OR 0.49; 95% CI 0.27 to 0.89) and pain during surgery (OR 0.75; 95% CI 0.61 to 0.93), scrotal pain (OR 0.63; 95% 0.50 to 0.80), and incisional infection (OR 0.21; 95% CI 0.06 to 0.78) during follow up than the standard incisional group. Both studies found less hematoma with the no-scalpel technique (OR 0.23; 95% CI 0.15 to 0.36). Operations using the no-scalpel approach were faster and had a quicker resumption of sexual activity. Neither trial found differences in vasectomy effectiveness between the two approaches to the vas.
A meta-analysis 2 ascertaining post-vasectomy pain following scalpel or non-scalpel vasectomy included 18 articles. Study follow-up ranged from 2 weeks to 37 years and sample sizes from 12 to 723 patients. The overall incidence of post-vasectomy pain was 15% (95% CI 9% to 25%); for scalpel 24% (95% CI 15% to 36%), and for non-scalpel technique 7% (95% CI 4% to 13%). Post-vasectomy pain syndrome occurred in 5% (95% CI 3% to 8%) of subjects, with similar estimates for both techniques.
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