EFFICACY AND COMPLICATIONS ASSOCIATED WITH VASECTOMY IN 2 CLINICS OF THE REGION OF QUEBEC-CITY

OBJECTIVE To compare the efficacy of, and complications associated wit h, vasectomies performed in two medical clinics. DESIGN Retrospective cohort study. SETTING A private medical clinic and a family planning c linic at a teaching hospital in the Quebec City region, where one doct or performs all surgery. PARTICIPANTS The 1223 men who underwent a fir st vasectomy between January 1994 and February 1996. INTERVENTIONS Iso lation 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 fami ly planning clinic (n = 448), a combination of cauterisation of the ab dominal end of the vas deferens, leaving the testicular end open, and faascial interposition with a clip was used. MAIN OUTCOME MEASURES Rat e of postoperative complications (painful granuloma; noninfectious inf lammation of the vas deferens, epididymis, and testes; hematoma; infec tion; undiagnosed pain) and rate of recanalization (early and late). R ESULTS At the private clinic, 39 patients (5.0%) consulted for postope rative complications, compared with 55 patients (12.3%) at the family planning clinic (chi(1)(2) = 21.0; P < .001). Of the patients who unde rwent semen analysis, 15 (2.8%) at the private clinic and 4 (1.2%) at the family planning clinic experienced early or late recanalization (c hi(1)(2) = 2.2; P < .14). CONCLUSION The rate of consultation for post operative complications was lower at the private clinic than at the fa mily 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.