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[Efficacy and complications associated with vasectomies in two clinics in the Quebec region]
M Labrecque1, L Bédard, L Laperrière
1Département de médecine familiale de l'Université Laval. michel.labrecque@mfa.ulaval.ca
Objective:
To compare the efficacy of, and complications associated with, vasectomies performed in two medical clinics.
Design:
Retrospective cohort study.
Setting:
A private medical clinic and a family planning clinic at a teaching hospital in the Quebec City region, where one doctor performs all surgery.
Participants:
The 1223 men who underwent a first vasectomy between January 1994 and February 1996.
Interventions:
Isolations of the vas deferens through the scrotum was performed using the no-scalpel technique in both clinics. At the private clinic (n = 775), vasectomy was performed by ligature with tantalum clips. At the family planning clinic (n = 448), a combination of cauterisation of the abdominal end of the vas deferens, leaving the testicular end open, and fascial interposition with a clip was used.
Main Outcome Measures:
Rate of postoperative complications (painful granuloma; noninfectious inflammation of the vas deferens, epididymis, and testes; hematoma; infection; undiagnosed pain) and rate of recanalization (early and late).
Results:
At the private clinic, 39 patients (5.0%) consulted for postoperative complications, compared with 55 patients (12.3%) at the family planning clinic (chi (2)1 = 21.0; P < 0.001). Of the patients who underwent semen analysis, 15 (2.8%) at the private clinic and 4 (1.2%) at the family planning clinic experienced early or late recanalization (chi (2)1 = 2.2; P < .14).
Conclusion:
The rate of consultation for postoperative complications was lower at the private clinic than at the family planning clinic, but the efficacy of the procedure appeared to be higher at the family planning clinic. The surgical techniques used at the two clinics might partially explain these differences.