Objective: To compare pain, discomfort, complications and convalescence during and after vasectomy performed conventionally or using the Li 'no-scalpel' method.
Patients and methods: Between March 1993 and May 1995, 256 men were vasectomized at two city hospitals in Copenhagen; half of the patients underwent the conventional technique at one hospital and the remaining half the Li method at the other. The two groups were matched for the time at which they underwent surgery and therefore for the duration of follow-up. A questionnaire was sent to all patients, in which they scored pain and discomfort using a 10 cm visual analogue scale (VAS). The reproducibility of measurements was tested on 10 patients who had answered the same questions 1.5-2 years earlier.
Results: Men vasectomized using the Li method experienced less pain at rest after the first week (P = 0.05) and less use of analgesics (P < 0.001), had fewer infections (P = 0.0015) and contacts with their physician (P = 0.0078) than those conventionally vasectomized. There were no significant differences between the groups for pain and discomfort during surgery and in the first week after vasectomy, frequency of bleeding, haematoma, oedema, granuloma, pain at activity, absence from work, vasectomy failure by sperm analysis, sexual activity and satisfaction with the cosmetic result (all P > 0.05).
Conclusion: Vasectomy using the Li method reduced post-operative pain, the use of analgesics, the frequency of infections and contacts with a physician when compared with the conventional procedure.
PIP: A comparative study of conventional vasectomy and the no-scalpel Li method indicated that the Li method reduces postoperative pain, the use of analgesics, the frequency of infections, and contacts with a physician. Enrolled in the study were 256 men undergoing male sterilization at 2 city hospitals in Copenhagen, Denmark, during 1993-95. The 2 groups were matched for the time at which they underwent surgery. In July 1995, a questionnaire was mailed to all 256 vasectomy acceptors (median duration since surgery, 14 months; range, 2-27 months). Pain and discomfort were self-assessed on a 10-cm visual analogue scale. There were no significant differences between the 2 techniques for pain and discomfort during the procedure or in the first postoperative week. However, the proportion of patients who experienced pain at rest after the first week or used analgesics was markedly lower in the Li vasectomy group (11% and 29%, respectively) than in the conventional vasectomy group (22% and 53%, respectively). Differences were even more marked in terms of the number of infections and contacts with physicians: 4% and 8%, respectively, in the Li group and 18% and 22%, respectively, in the traditional vasectomy group. These findings are presumed to reflect the fact that the Li procedure is less invasive and the wound is not closed.