NO-SCALPEL VASECTOMY - REVIEW OF THE FIRST 1,000 CASES IN A FAMILY MEDICINE UNIT

In Mexico, the Mexican Institute of Social Security (IMSS) had adopted the no-scalpel vasectomy technique by the end of 1989. The technique was described by Dr. Li Shunquiang in 1974, and more than 60 million n o-scalpel vasectomies have been performed in 26 countries. Among the a dvantages with no-scalpel vasectomy is that it has fewer complications (0.4%) compared to the traditional technique (3.1%). We studied 1,000 clinical charts of the subjects operated on between January, 1990 and January, 1993, with the objective of reporting our experiences as wel l as analyzing whether there existed a correlation between the subject 's social and demographic characteristics and the number of control sp ermatic counts he attended postoperatively. In 97.9% of the cases, sub jects had no postoperative hemorrhage or hematoma. None of the subject s had a surgical wound infection. In addition, 54.4% of the subjects c ame to the first control spermatic count, 39.7% came to the second, an d only 18.4% came to all three controls. In an attempt to find a chara cteristic which defined the subject who attends his postoperative cont rol spermatic counts, we found an association using chi(2) between the ;attendance at two controls with the subjects who had been married fro m 6 - 10 years (p = 0.059), and with the subjects who had an income of three minimum wages. Regarding the attendance at all three controls, we found an association with subjects who had an income of two minimum wages (p = 0.037). We also found a weak correlation between the atten dance at all three controls and the reason reported for not having mor e children (the couple did not want more children) (r = 0.07; p = 0.02 5) and with the manner in which the subjects were referred to the clin ic (came on their own initiative) (r = 0.09; p = 0.006). Finally, we c onsider that no-scalpel vasectomy can be implemented as an adequate fa mily planning method in Mexico's primary care centers. The lack of ade quate attendance at postoperative control spermatic counts does not se em to have an important association with the subject's demographic cha racteristics, so it appears warranted that this issue be studied from a psychological point of view.