- in Overview
As mentioned in the FAQ, there are basically three major procedure types, and a mixture of methods of accessing, cutting and sealing the vas deferens. The main variants being Traditional, No Scalpel (NSV) and Open Ended. There is a fourth method practiced by the Marie Stopes (MSI) clinics in various countries. The method is known as either the Marie Stopes electrocautery no-scalpel vasectomy, or Percutaneous Electrocoagulation Vasectomy technique. The link to the procedure on the MSI site is a .PDF file. There are some diagrams, but the information does not make it clear that the MSI method is different to other methods of vasectomy, and in what respects.
The difference between the MSI method and other techniques, is that with the MSI method the vas deferens is cauterized without excision of vas deferens, and without fascial interposition. MSI are a provider of vasectomies in developed and developing countries. The advantages MSI claim for the method are that as compared to standard incision vasectomy, recovery time is quicker, and it’s easier to perform in remote areas of developing countries than standard incision vasectomy.
The MSI site has a video clip containing interviews with patients, commentary from the doctor and video of the MSI technique being performed. Scroll down the page, and the link to watch the video is on the right side.
There are 3 published clinical studies available – the primary author being Tim Black (CEO of MSI) in all cases. The first one was published in 1989, and titled “The percutaneous Electrocoagulation vasectomy technique – a comparative trial with the standard incision technique at Marie Stopes House, London. The key points of this study are:-
- Study carried out in 1985 on 101 men.
- Some men had standard vasectomy, and others had the new Percutaneous Electrocoagulation Vasectomy procedure. It is not mentioned in what proportion.
- Semen specimens were tested at 10 and 12 weeks after surgery. Men were telephoned at 2, 12 and 24 weeks post-surgery to elicit complications and complaints.
- Half of the men having the standard incision procedure and about one-third of the men undergoing the percutaneous procedure complained of discomfort during the surgery.
- At the two-week telephone contact, 23% of those having the standard incision and 66% of those having the percutaneous procedure reported complications.
- There were few complications or complaints reported at the long-term follow-up contacts with either method; although twice as many men in the percutaneous group were not declared sterile by the end of the study period.
- Failure rates were 2.0% for the standard incision procedure and 7.8% for the percutaneous approach.
The second study, published in 2003 is titled “Comparison of Marie Stopes scalpel and electrocautery no-scalpel vasectomy techniques”. More information on this study can be obtained by following the links from the 2003 document. The key points of this study are:-
- 325 men undergoing vasectomy between January and June 1999.
- The ENSV technique was marginally quicker to perform. Pain levels intra-operatively were comparable.
- The ENSV group experienced less pain and bleeding from the wound postoperatively and were quicker to heal.
- For men who experienced postoperative problems, the time taken to return to work was marginally better in the ENSV group.
- The time taken to return to sexual activity was marginally faster in the ENSV group.
- CONCLUSION: The ENSV procedure appears to be suitable for mass application in locations where electricity is available.
The third study was published in 2002 and titled “The evolution of the Marie Stopes electrocautery no-scalpel vasectomy procedure”. It’s available as a free full text article in .PDF format at ingenta.com. You will need to sign up to get it, but that is also free. The article has information about MSI, describes the evolution of the procedure and has some comparative data from all MSI centres worldwide over a 10 year period. This paper was discussed at a conference in December 2003 in Washington, D.C by Tim Black, CEO of Marie Stopes International (MSI). The data presented was based on a series of 18,000 vasectomies.
The above document is referenced in a 2004 article Vasectomy surgical techniques: a systematic review by Labrecque, Dufresne, Barone and St-Hilaire. The link takes you to a free, full text version of the article. The key points mentioned are:-
- The observed occlusive failure risk was 0.6%, a figure comparable to that reported in most of the major comparative studies available.
- The risk of contraceptive failure was 0.03%
The Royal College of Obstetricians and Gynaecologists guidelines issued in 2004 mentions the technique and comments that it may be less likely to be reversible than other techniques, as it causes more damage to the vas deferens. The guidelines also highlight areas were information is scant, or in need of further research. Therefore, it should be made clear that this comment is opinion based, and may not be accurate, or backed up by sound research.